Giving directions in virtual reality: Resources for managing fragmented perception

Extended-Reality Technologies: An Overview of Emerging Applications in Medical Education and Clinical Care.

Primary school students often find it difficult to differentiate two dimensional and three-dimensional geometric shapes. Taking advantage of the ability of Virtual Reality (VR) and Augmented Reality (AR) to visualize 3D objects, we evaluate the potential of VR and AR technologies for teaching the lesson of geometric solids to primary school children. To the best of our knowledge there are no previous cases in the literature describing a comparative evaluation of VR and AR technologies in education, and more specifically in the field of mathematics for primary school children. An experimental evaluation was staged to test the following hypothesis: Hypothesis 1: VR and AR applications make the teaching of mathematics more interactive and interesting and they also contribute to a more efficient learning and understanding of mathematical concepts. Hypothesis 2: The use of VR applications is more effective when compared to AR applications for mathematics teaching activities. For the needs of the experimental evaluation, we designed a lesson plan comprised of three activities: Classification of shapes into solid or plane shapes, identification of solid shapes appearing in a typical city environment, and classification of solid shapes. The lesson plan was implemented based on the traditional method that utilizes printed material, three related VR and three AR applications. The developed VR and AR applications for the current research do not require specialized equipment. For the AR applications, the users only need to use their mobile device or tablet and for VR applications they only need to use a mobile phone and low-cost virtual reality glasses. As part of the study 30 fourth, fifth and sixth class primary school students were divided equally into the control group who used the traditional teaching method, and the AR and VR groups who used AR and VR applications respectively. Participants were provided with questionnaires before (pre-test) and after the test (post-test) to measure factors such as user attention, presence, enjoyment, science knowledge, auditory knowledge, and visual knowledge. According to the results, new technologies in education in the form of virtual and augmented reality improve interactivity and student interest in mathematics education, contributing to more efficient learning and understanding of mathematical concepts when compared to traditional teaching methods. No significant difference was observed between virtual and augmented reality technologies with regards to the efficiency of the methods that contribute to the learning of mathematics, suggesting that both virtual and augmented reality display similar potential for educational activities in Mathematics. Based on statistical evidence Hypothesis 1 was accepted and Hypothesis 2 was rejected. The current research is one of the first attempts ever to compare VR and AR technologies for Mathematics teaching activities in primary school. The findings of our research can provide valuable feedback to educators and developers who plan to use or develop VR or AR technologies for educational activities. Given that these days VR and AR applications, like the ones used in the experimental evaluation, do not require highly specialized equipment, the introduction of AR and VR based activities both for in-class and extra curriculum activities provide a promising way for more efficient Mathematics training activities.

Previous studies from our institution have demonstrated the value of pharmacology educational games in promoting recall practice and topic interest necessary for medical students to learn pharmacology. At our institution, pharmacology and other basic science topic games are embedded into curricular activities, in-class, faculty facilitated team competitions, and self-learning modules (SLMs). Little work has been done to assess student perceptions of virtual versus in-class games, despite the fact that developing effective virtual pharmacology learning tools has become essential due to curricular changes adapting to the COVID-19 pandemic. The goal of this pilot study was to survey students on their perceptions and preferences for in-class, faculty facilitated games vs. virtual electronic games. Since we hypothesized that students’ perceptions of feedback would differ between in-class and virtual games, we additionally surveyed students on their preferences for enriched auditory vs. simple text feedback within virtual games. Methods An end of module survey was sent to all students in a second-year medical school (M2) systems course (N=110 total, 70% participated) to get a broad class perceptive. A subset of M2's (N=14) volunteered to beta test pharmacology virtual trivia games with feedback that ranged from plain text answers to enriched auditory feedback performed by actors (varied genders, ages, personalities) and feedback from a trusted pharmacology instructor offering coaching and praise similar to classroom feedback. Results Approximately 70% of students reported using the games and answered survey items, with most affirming (reported as % agreeing/strongly agreeing) that virtual and in-class games promoted active learning (80%), integrated basic and clinical concepts (84%), and stimulated thinking (84%). About 60% preferred participating in or watching videos of in-class games with auditory feedback from instructors. Of those with a preference, 50% preferred Trivia while 25% preferred Jeopardy. Of the 14 students beta testing virtual trivia games, most agreed (83%) that the virtual games increased pharmacology interest and promoted active learning, though fewer than 25% preferred enriched auditory feedback from actors over simple written text. A majority (61%) agreed that hearing the voice of a trusted professor was beneficial. Conclusion Most M2 students used game-based methods and highly valued either in-class team or virtual games for promoting topic interest, active learning, and integration. Students valued coaching and auditory feedback from a trusted professor in either classroom or virtual games. However, most students preferred simple text feedback over auditory, unless the feedback voice was the pharmacology instructor's. Thus, virtual pharmacology educational games with simple feedback designs appear to be engaging virtual teaching tools for pharmacology learning in the age of COVID and beyond.

User Experience and Engagement in the Reality–Virtuality Continuum: A Special Issue Guest Editorial

The aim of this article is to study the specifics of using virtual reality technology in the process of teaching foreign languages. The scientific and methodological literature on this issue is analyzed, and as a result of the analysis, the advantages, disadvantages, and difficulties of implementing this technology are identified. Despite the prospects of using VR technology in education, practical application is necessary to assess its effectiveness. Based on the obtained information, an attempt is made to provide recommendations for overcoming the difficulties of implementing and using VR in language education. These recommendations include supporting innovations in education, increasing teachers' competence in the field of virtual reality, expanding the diversity of VR content, standardizing the use of this technology in education, and controlling its impact on students' health.The research also concludes that the concept of "virtual reality in language education" requires clarification, and an attempt is made to define it. Key principles (didactic expediency, professional orientation, interactivity, connection of theory with practice) and approaches applicable in the process of using VR in teaching foreign languages are identified and substantiated.   References Krasnova T.I. The Potential of Immersive Virtual Reality in Foreign Language Learning. 2023;1(98):89–91. (In Russ.) Hukalenko Y.S. Foreign Language Learning (Using English as an Example) with Virtual Reality Technology: A Review of Main Developments. News of the Eastern Institute. 2021; 2(50):118–128. (In Russ.) Bonner E., Reinders H. Augmented and Virtual Reality in the Language Classroom: Practical Ideas. Teaching English with Technology. 2018;3:33–53. Kotenko V.V. Problems and Opportunities of Using Augmented and Virtual Reality Technologies in Foreign Language Teaching. Lesgaft University Scientific Notes. 2020;3(181): 252–258. (In Russ.) Konnova Z.I., Semenova G.V. Augmented and Virtual Realities Technologies: Innovations in Foreign Language Teaching at University. Scientific Result. Pedagogy and Psychology of Education. 2021;3:53–65. (In Russ.) Borscheva V.V. Virtual Reality in Language Education: The Potential of Technology. Pedagogy and Psychology of Education. 2018;1:64–70. (In Russ.) Rolgaiser A.A. Application of Virtual and Augmented Reality Technologies in Foreign Language Teaching at University. Society: Sociology, Psychology, Pedagogy. 2022;5(97): 170–173. (In Russ.) Arvanitis P. VR vs AR are Suitable for the Development of Linguistic Skills in Second Language Teaching. INTED2019 Proceedings. 2019:2222–2228. Starodubtseva E.A. The Use of Virtual Reality Technology in Foreign Language Learning at University. Humanities Sciences. Bulletin of the Financial University. 2022;1:110–113. (In Russ.) Taran V.N. The Use of Augmented Reality in Teaching. Problems of Modern Pedagogical Education. 2018;2:333–337. (In Russ.) Dobrova V.V., Labzina P.G. Virtual Reality in Foreign Language Teaching. Bulletin of the Samara State Technical University. Series Psychological and Pedagogical Sciences. 2016; 4(32):55–60. (In Russ.) Troepolskaya A.P. Virtual Reality in Foreign Language Learning. 2022; 4(68):76–81. (In Russ.) Labzina P.G., Gureev M.V., Zhabin M.E., Novalov E.I. Principles of Teaching Professionally Oriented Foreign Language in Virtual Reality. Bulletin of the Samara State Technical University. Series Psychological and Pedagogical Sciences. 2017;4(36):79–89. (In Russ.) Rostovtseva P.P. Virtual Reality in the Foreign Language Learning Process. MNKO. 2023;2(99):233–235. (In Russ.) Krasnova T.I. Innovative Language Learning: Research on Immersive Virtual Environments. Society: Sociology, Psychology, Pedagogy. 2023;3(107):119–123. (In Russ.) Ivanova A.V. Virtual and Augmented Reality Technologies: Opportunities and Barriers to Application. Strategic Decisions and Risk Management. 2018;3(106):88–107. (In Russ.) Shakirova A.A. Digital Tools in Foreign Language Teaching at the University. Kazan Linguistic Journal. 2022;5(2):257–269. (In ) Krylova A.S. The Use of Augmented Reality for Educational Purposes. European Science. 2016;6(16):87–88. (In Russ.)  

The article is devoted to the problem and features of the use of virtual and augmented reality at general school. The integration of virtual reality (VR) and augmented reality (AR) in educational environment has opened up new possibilities for engaging and immersive learning experiences. This paper aims to explore the features of participants' interaction within an educational context using VR and AR technologies. To achieve the purpose of our study and also to clarify the problem of determining the features of interaction models of participants in the educational process of a general education institution using virtual and augmented reality we used the following methods: systematic and comparative analysis of pedagogical, psychological, philosophical and sociological works, methodological and specialized literature; analysis of the pedagogical experience of using virtual and augmented reality in general school; synthesis and generalization to formulate the main points of the study; interpretation of the research results. A research study was conducted in a general educational institution, where an educational project using virtual and augmented reality was developed and implemented. The purpose of the project was to investigate the issues surrounding the interaction among participants in the educational process when utilizing these technologies. The results of the questionnaire showed the following: the participants' interaction in the educational process with the use of VR needs improvement, methodological recommendations and research on the organization of this environment for various purposes, such as, for example, students' research of new educational material, performance of laboratory work, joint work of students on research, instructions for the teacher's activities in working with students in VR, etc.; the participants’ interaction in the educational process with the use of AR is best understood by teachers and students, they use both ready-made AR technologies and personally created ones. We concluded that the use of virtual and augmented reality technologies in the educational process provides a wealth of teaching and learning resources that can enhance the learning experience and free participants from limitations in time and space. However, the effective organization of interaction between participants in the educational process using VR and AR requires careful consideration of educational space and pedagogical and methodological recommendations.

Reality for Cybernauts Sergio Sismondo Introduction: virtual reality as a metaphysical laboratory Virtual reality (VR) is a wonderfully successful misnomer. To the extent that VR is reality, there is little virtual about it. I should qualify those claims right away: virtual reality is virtual in the derivative sense in which “virtual” has come to be a synonym for computer-based, but that sense is a result rather than a precondition of VR’s cultural success. VR has provided a path from an old meaning of “virtual” to a new one. The old meaning, what we could call virtual(1), is: in effect, but not actual. The meaning that is new to the last decades of the 20th century is virtual(2): simulated on or mediated by a computer. Many cybernauts have realized that VR is not merely virtually(1) real—an oxymoron?—and therefore are arguing that it is virtual(2) reality, real but computer-based. In so doing they have not merely added a new meaning to the term “virtual,” but have revamped talk of reality. At a time when skeptical humanists and others are more and more cautious about reality, VR enthusiasts are giving new life to words like “real” and “reality,” using them constantly, and with a variety of meanings. The best VR is described as “really real” and is contrasted with “real reality,” yet neither phrase fully makes sense without at least some confusion about meanings of “real.” At the same time, some cyberphiles and cybercritics have been proclaiming the death of reality. If we could create environments that have the look and feel that we expect from everyday reality, what is left of the “real” thing? Why should we care about it? Michael Heim says that “with its virtual environments and simulated worlds, cyberspace is a metaphysical laboratory, a tool for examining our very sense of reality” (83). Heim may be right that cyberspace—or in my case VR—is a metaphysical laboratory, but his laboratory is largely unbuilt. Currently-available VR, for example, is more crude as a metaphysical laboratory than are our imaginations, literature, and thought experiments. For my purposes the limitations of existing VR are unimportant: my intention here is, following Heim, to use VR to examine “our very sense of reality,” but in that I want to look at our use of the term “reality” and the presuppositions of that use. Along the way I take issue with some of the wilder claims about VR’s effects on reality. Although there is no one consistent picture of reality implicit in talk about VR, there are at least some common images. Some of those images are exactly what are needed to revamp talk of reality, and some are misguided. Some VR talk, for example, reinforces an impoverished sense of reality in its dominating images of levels and degrees; my preferred images are more chaotic and multi-dimensional. In order to show why we should prefer some images of reality, in the second half of this essay I put forward a general account of reality talk. That account makes space for (though does not guarantee) the reality of VR, and much more besides. For my project here we do not have to be full-fledged cybernauts. That is a good thing, because this essay is written by yet another interloper into VR. I haven’t made the tours of labs where systems like RB2 (“Reality Built for Two”) or gadgets like the DataGlove have been developed. I spend little of my time browsing Mondo 2000, and have tested out only the most publicly available virtual environments, computer games like “Doom,” and high-tech video games like “Dactyl Nightmare.” Donning the latter’s 3-D video helmet and battling its schematic pterodactyls even put me off-balance and made me slightly nauseous. All of that should place me as a text-based critic whose access to VR and cyberculture is largely through the guidance of texts. Therefore my text displays many signs of my interloper status, in the form of references to the canonizers and the canonized agents of the history of VR. The virtualization of reality? Our point is thus a very elementary...

The study examines the problem of using augmented and virtual reality in the process of blended learning in general secondary education. Analysis of recent research and publications has shown that the use of augmented and virtual reality in the educational process has been considered by scientists. However, the target group in these studies is students of higher education institutions. Most of the works of scientists are devoted to the problem of introducing augmented reality into the traditional educational process. At the same time, the use of augmented and virtual reality technologies in the process of blended learning remains virtually unexplored. The study analyzes the meaning of the concept of "blended learning". The conceptual principles of blended learning are considered. It has been found that scholars differ in their understanding of the concept of "blended learning". Sometimes researchers distinguish between the components of blended learning: full-time and online learning. The study presents the special advantages of blended learning and the taxonomy of blended learning. It was found that there are some difficulties in implementing blended learning. The article outlines the practical use of virtual and augmented reality. The definition of augmented and virtual reality is given. The mixed reality is considered as a separate kind of notion. Separate applications of virtual and augmented reality that can be used in the process of blended learning are considered (MEL Chemistry VR; Anatomyou VR; Google Expeditions; EON-XR). As a result of the study, the authors propose possible ways to use augmented reality in the educational process. The model of using augmented and virtual reality in blended learning in general secondary education institutions was designed. It consists of the following blocks: goal; teacher’s activity; forms of education; teaching methods; teaching aids; organizational forms of education; pupil activity and results. Based on the model, the methodology of using augmented and virtual reality in blended learning in general secondary education was developed. The methodology contains the following components: target component, content component, technological component and resultant component. The methodology is quite universal and can be used for any subject in general secondary education. The types of lessons in which it is expedient to use augmented (AR) and virtual reality(VR) are determined. Recommendations are given at which stage of the lesson it is better to use AR and VR tools (depending on the type of lesson).

In the previous chapter, I have presented different types of computer-based applications, particularly considering the umbrella term Virtual Reality (VR) ranging from 2D VR presented on a 2D computer monitor, Augmented (Virtual) Reality, Immersive (Virtual) Reality, and Mixed (Virtual) Reality. Also, by now, you know the use of the VR-based solutions in addressing skill deficits of children with autism. Additionally, you are aware of the numerous advantages of using VR particularly for individuals with autism. The VR can serve as an excellent tool in the hands of the interventionists for offering different training scenarios to the users, controllable levels of challenge based on an individual’s specific abilities, adaptive skill learning environment, etc. Researchers around the globe have been using VR for individuals with autism while offering them tasks that can contribute to improvement in social communication, emotion recognition, joint attention, etc. Offering skill training in at least some of these core deficit areas is important since the children with autism are often characterized by deficit in making socially appropriate reciprocation while carrying out back-and-forth communication with social partners, understanding facial emotional expressions, following the gaze of a social partner to triangulate to an object of interest through shared attention, etc. In this chapter, I will present detailed information on the building of the various components, such as Graphical User Interface, virtual characters, individualized and adaptive feedback of 2D VR-based applications.

Virtual reality (VR) and augmented reality (AR) have been combined with physical rehabilitation and psychological treatments to improve patients' emotional reactions, body image, and physical function. Nonetheless, no detailed investigation assessed the relationship between VR or AR manual therapies (MTs), which are touch-based approaches that involve the manipulation of tissues for relieving pain and improving balance, postural stability and well-being in several pathological conditions. The present review attempts to explore whether and how VR and AR might be integrated with MTs to improve patient care, with particular attention to balance and to fields like chronic pain that need an approach that engages both mind and body. MTs rely essentially on touch to induce tactile, proprioceptive, and interoceptive stimulations, whereas VR and AR rely mainly on visual, auditory, and proprioceptive stimulations. MTs might increase patients' overall immersion in the virtual experience by inducing parasympathetic tone and relaxing the mind, thus enhancing VR and AR effects. VR and AR could help manual therapists overcome patients' negative beliefs about pain, address pain-related emotional issues, and educate them about functional posture and movements. VR and AR could also engage and change the sensorimotor neural maps that the brain uses to cope with environmental stressors. Hence, combining MTs with VR and AR could define a whole mind-body intervention that uses psychological, interoceptive, and exteroceptive stimulations for rebalancing sensorimotor integration, distorted perceptions, including visual, and body images. Regarding the technology needed to integrate VR and AR with MTs, head-mounted displays could be the most suitable devices due to being low-cost, also allowing patients to follow VR therapy at home. There is enough evidence to argue that integrating MTs with VR and AR could help manual therapists offer patients better and comprehensive treatments. However, therapists need valid tools to identify which patients would benefit from VR and AR to avoid potential adverse effects, and both therapists and patients have to be involved in the development of VR and AR applications to define truly patient-centered therapies. Furthermore, future studies should assess whether the integration between MTs and VR or AR is practically feasible, safe, and clinically useful.

Рассматриваются особенности применения технологий VR (виртуальной реальности) и AR (дополненной реальности) организациями финансовой сферы. Определяется специфика технологий виртуальной и дополненной реальности. Последовательно представлена история их продвижения на рынки, отмечены наиболее яркие факты, результаты совершенствования в контексте технологического прогресса (Sensorama, head-mounted display, «Кинокарта Аспена», устройство Eye Tap, коммерческая система RB2, VR-консоль компании SEGA Games Co., очки Oculus Rift и др.). Отмечаются области и возможности их применения. Изучена степень проникновения технологий виртуальной и дополненной реальности в деятельность финансовых организаций. Указаны основные направления их применения: приведены конкретные примеры интеграции VR- и AR-технологий в работу финансовых организаций. Систематизированы такие цели применения AR- и VR-технологий в финансовой сфере, как упрощение получения и обработки информации клиентами посредством приема визуализации, сохранение безопасности, маркетинговые коммуникативные цели и др. В результате проведенного исследования обозначены тенденции использования технологий на финансовом рынке, выявлены возможности их развития и перспективы применения, факторы, сдерживающие их развитие, определены и систематизированы преимущества и недостатки как самих технологий, так и функционирования этих технологий в финансовой среде. В заключение сделан вывод о том, что применение VR- и AR-технологий позволит финансовым организациям укрепить свои конкурентные позиции на рынке, а клиентам финансовых организаций — создать собственную безопасную онлайн-среду, в которой они смогут управлять своими деньгами и инвестициями и совершать транзакции. The features of the use of VR (virtual reality) and AR (augmented reality) technologies by financial organizations are considered. The specifics of virtual and augmented reality technologies are determined. The history of their promotion to markets is presented in a coherent manner, highlighting key facts, the results of improvements in the context of technological advances (Sensorama, head-mounted display, Aspen’s Cinema Map, Eye Tap device, RB2 commercial system, VR-console of SEGA Games Co., glasses Oculus Rift and more). Areas and possibilities of their application are noted. The areas and possibilities of their application are highlighted. The degree of penetration of virtual and augmented reality technologies in the activities of financial institutions is explored. The main directions of their application are indicated: specific examples of integration of VR- and AR-technologies in the work of financial institutions are given. The goals of using AR and VR technologies in the financial sector, such as simplifying the receipt and processing of information by clients through the reception of visualization, maintaining security, marketing communication goals, etc., are systematized. As a result of the study, trends in the use of the technologies in the financial market are identified, opportunities for their development and prospects of application, factors that restrain their development are identified, the advantages and disadvantages of both the technologies themselves and the functioning of these technologies in the financial environment are identified and systematized. It is concluded that the use of VR and AR technologies will allow financial institutions to strengthen their competitive positions in the market, and let the clients of financial institutions create their own secure online environment in which they can manage their money and investments and make transactions.

Augmented Reality (AR) and Virtual Reality (VR) technologies are increasingly becoming integral to educational and training contexts, yet comparative analyses of their effects on simulator sickness and user experience remain limited. Recent advancements in AR/VR headsets, such as the Meta Quest 3, now allow virtual and augmented reality experiences to be delivered through a single device. However, previous research comparing user experiences between virtual and augmented reality did not account for the use of a unified headset in their investigation. This study aims to investigate the differential effects of AR and VR on users’ simulator sickness, engagement, mental workload, and performance, and usability of the training environment. A training module was developed in Unity 3D for both AR and VR focusing on 3D printing using a powder bed fusion (PBF) printer. A within-subject assignment of factors explored the comparison of ten participants’ experiences regarding simulation sickness and printing experiences and performances. Each participant went through the same tasks under simulated environments to explore the implications of AR and VR on user experience. The study found that there was no statistically significant difference in motivation and user experiences between AR and VR using Meta Quest 3. Moreover, the users experienced comparatively higher simulator sickness in VR than in AR. These findings will not only help to fill the gaps in comparative studies of AR and VR but will also help to inform future technological deployments in educational and professional training scenarios.

This chapter introduces virtual reality and augmented reality as a basis for simulation visualization. It shows how these technologies can support simulation visualization and gives important considerations about the use of simulation in virtual and augmented reality environments. Hardware and software features, as well as user interface and examples related to simulation, using and supporting virtual reality and augmented reality, are discussed, stressing their benefits and disadvantages. The chapter intends to discuss virtual and augmented reality in the context of simulation, emphasizing the visualization of data and behavior of systems. The importance of simulation to give dynamic and realistic behaviors to virtual and augmented reality is also pointed out. The work indicates that understanding the integrated use of virtual reality and simulation should create better conditions to the development of innovative simulation environments as well as to the improvement of virtual and augmented reality environments.

This chapter introduces virtual reality and augmented reality as a basis for simulation visualization. It shows how these technologies can support simulation visualization and gives important considerations about the use of simulation in virtual and augmented reality environments. Hardware and software features, as well as user interface and examples related to simulation, using and supporting virtual reality and augmented reality, are discussed, stressing their benefits and disadvantages. The chapter intends to discuss virtual and augmented reality in the context of simulation, emphasizing the visualization of data and behavior of systems. The importance of simulation to give dynamic and realistic behaviors to virtual and augmented reality is also pointed out. The work indicates that understanding the integrated use of virtual reality and simulation should create better conditions to the development of innovative simulation environments as well as to the improvement of virtual and augmented reality environments.

Objetivo: Realizar uma análise comparativa de medidas de erros após o treino com jogos de dardos virtual e real. Metodologia: Participaram do estudo 15 pacientes com Acidente Vascular Cerebral (AVC) (10 homens) e 12 indivíduos saudáveis (7 homens). O jogo virtual utilizado foi o Kinect Sports do Xbox 360 Kinect®. Os participantes realizaram 15 tentativas em cada jogo. Foram calculados os erros absoluto (EA), constante (EC) e variável (EV). Os dados foram analisados pela ANOVA. Resultados: Quanto ao EA observou-se diferença significativa entre os pacientes e saudáveis no jogo virtual (p=0,003) e no jogo real (p= 0,0001). Também houve diferença do EA entre os jogos virtual e real para os pacientes (p= 0,0001). No EC não foi encontrada diferença significativa entre pacientes e saudáveis no jogo virtual (p=0,355) e no jogo real (p= 0,544). Também não houve diferença do EC entre os jogos virtual e real para os pacientes (p= 0,452). Pela análise do EV não foi verificada diferença significativa entre pacientes e saudáveis no jogo virtual (p=0,406), mas houve no jogo real (p= 0,0001). Não houve diferença significativa do EV entre os jogos virtual e real para os pacientes (p= 0,579). Conclusão: Os resultados encontrados indicaram que os pacientes tiveram menor precisão, maior consistência de erros e menor variabilidade do desempenho. O jogo virtual proporcionou melhores resultados para os pacientes em comparação ao jogo real, o que pode ser de significativa importância para o planejamento da reabilitação motora dos pacientes com AVC.