Usability and Effectiveness of Immersive Virtual Grocery Shopping for Assessing Cognitive Fatigue in Healthy Controls: Protocol for a Randomized Controlled Trial.

James A Holdnack,Patricia Flatley Brennan

doi:10.2196/28073

Abstract

BackgroundCognitive fatigue (CF) is a human response to stimulation and stress and is a common comorbidity in many medical conditions that can result in serious consequences; however, studying CF under controlled conditions is difficult. Immersive virtual reality provides an experimental environment that enables the precise measurement of the response of an individual to complex stimuli in a controlled environment.ObjectiveWe aim to examine the development of an immersive virtual shopping experience to measure subjective and objective indicators of CF induced by instrumental activities of daily living. MethodsWe will recruit 84 healthy participants (aged 18-75 years) for a 2-phase study. Phase 1 is a user experience study for testing the software functionality, user interface, and realism of the virtual shopping environment. Phase 2 uses a 3-arm randomized controlled trial to determine the effect that the immersive environment has on fatigue. Participants will be randomized into 1 of 3 conditions exploring fatigue response during a typical human activity (grocery shopping). The level of cognitive and emotional challenges will change during each activity. The primary outcome of phase 1 is the experience of user interface difficulties. The primary outcome of phase 2 is self-reported CF. The core secondary phase 2 outcomes include subjective cognitive load, change in task performance behavior, and eye tracking. Phase 2 uses within-subject repeated measures analysis of variance to compare pre- and postfatigue measures under 3 conditions (control, cognitive challenge, and emotional challenge).ResultsThis study was approved by the scientific review committee of the National Institute of Nursing Research and was identified as an exempt study by the institutional review board of the National Institutes of Health. Data collection will begin in spring 2021.ConclusionsImmersive virtual reality may be a useful research platform for simulating the induction of CF associated with the cognitive and emotional challenges of instrumental activities of daily living.Trial RegistrationClinicalTrials.gov NCT04883359; http://clinicaltrials.gov/ct2/show/NCT04883359International Registered Report Identifier (IRRID)PRR1-10.2196/28073

Highlights

BackgroundThe application of digital technologies to improve the monitoring and treatment of chronic clinical conditions is an emerging field in medical research and practice
We identified immersive virtual reality (VR) grocery shopping as a suitable model to study fatigue associated with an instrumental activity of daily living National Institutes of Health (NIH) (IADL) because it provides familiar but complex visual stimuli, affords the opportunity to search and choose, and presents the participant with well-known but complex cognitive challenges, such as comparisons, discernment, and decision-making
This study was approved by the scientific review committee of the Nursing Research (NINR) and identified as an exempt study by the institutional review board of the NIH

Summary

Introduction

BackgroundThe application of digital technologies to improve the monitoring and treatment of chronic clinical conditions is an emerging field in medical research and practice. The steady increase in apps and digital devices developed to track health-related behaviors and monitor physiological data is a testament to the interest and potential powerful role that technology will play in the future of medicine. These tools may become most useful for aiding health care in the gaps between formal treatment (eg, hospital, clinic, and doctor visit) and day-to-day living in extended or chronic conditions. Conclusions: Immersive virtual reality may be a useful research platform for simulating the induction of CF associated with the cognitive and emotional challenges of instrumental activities of daily living. Trial Registration: ClinicalTrials.gov NCT04883359; http://clinicaltrials.gov/ct2/show/NCT04883359 International Registered Report Identifier (IRRID): PRR1-10.2196/28073

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