Using Virtual Reality to Reduce Stress in Adolescents: Mixed Methods Usability Study

Adolescent mental health is a growing public health issue, with 30% of teens reporting increased stress and 20% of adolescents suffering from depression. Given the scarcity and lack of scalability of mental health services available, the use of self-administered, evidence-based technologies to support adolescent mental health is both timely and imperative. We conducted a mixed-methods pilot study with 31 adolescents ages 14–19 (m = 17.97) to explore the self-administration of a nature-based virtual reality tool. Participant use of the VR environment ranged from 1 to 10 sessions (m = 6.6) at home over a 2-week period while reporting their daily stress and mood levels. All participants completed all of the study protocols, indicating our protocol was feasible and the VR environment engaging. Post-study interviews indicated that most participants found the VR tool to be relaxing and helpful with stress. The themes of Calm Down, Relaxation, and Escape emerged to articulate the participants’ experiences using the VR environment. Additionally, participants provided rich data regarding their preferences and activity in the VR environment as well as its effect on their emotional states. Although the sample size was insufficient to determine the impact on depression, we found a significant reduction in momentary stress as a result of using the VR tool. These preliminary data inform our own virtual reality environment design, but also provide evidence of the potential for self-administered virtual reality as a promising tool to support adolescent mental health.

The objective of this study was to construct systems for haptic virtual reality (VR) environment and to conduct an experiment to compare muscular activity during ball catching tasks in real and VR environments, where the level of the presence was evaluated. A ball catching task was demonstrated in two environments, where head-mounted display and SPIDAR-HS, the haptic presentation device using tensile force of the wire, were applied for constructing VR environment. As an index of dynamic muscular activity, forearm EMG signals were measured in the time course of a ball catching task. Average peak RMS value for forearm EMG in VR environment was 45.2% smaller than that in real environment. This difference was apparent because the amount of force generated by SPIDAR-HS was relatively lower than that made by the gravity force of the ball. On the other hand, the trends in dynamic muscular activities were similar for both environment, indicating that two tasks were fairly unique regardless the type of environments. It was concluded that the presence of VR was observable by the dynamic muscular changes during VR tasks with further adjustment of force levels required for the task in VR environment.

Background Freezing of gait (FoG) is a common target of rehabilitative interventions for people with Parkinson disease (PD). Virtual reality (VR) holds potential for advancing research and clinical management of FoG through flexible creation of FoG-provoking environments that are not easily or safely replicated in the clinic. Objective The aim of this study was to investigate whether VR environments that replicate FoG-provoking situations would exacerbate gait impairments associated with FoG compared to unobstructed VR and physical laboratory environments. Methods Gait characteristics (pace, rhythm, variability, asymmetry, and postural control domains) and festination were measured using motion capture while people with PD walked in VR environments based on FoG-provoking situations (doorway, hallway, and crowd environments) compared to unobstructed VR and physical laboratory environments. The effect of VR environments was assessed using one-way repeated measures ANOVAs with planned contrasts. Results Ten participants (mean age 74.1 years, 3 females, Hoehn and Yahr stage 2–3) with PD who self-reported FoG participated. Gait speed and step length were reduced in all VR environments compared to the physical laboratory. Step width was wider, step length was more variable, and festination was more common for some of the VR environments compared to the physical laboratory environment. Compared to the unobstructed virtual laboratory environment, step length was more variable in VR crowd and doorway environments. Conclusions The exacerbation of gait impairments that are characteristic precursors of FoG in FoG-provoking VR environments supports the potential utility of VR technology in the assessment and treatment of gait impairments in PD. Implications for rehabilitation Freezing increases fall risk and reduces quality of life in Parkinson disease (PD). Virtual reality (VR) can simulate visuospatial environments that provoke freezing. Immersive VR doorway, hallway, and crowd environments were developed. Gait speed slowed when people with PD walked overground in all VR environments. Step variability and festination increased in freeze-provoking environments.

The absence of constraints is one of the major limitations in current Virtual Reality (VR) environments. Without constraints, it is difficult to perform precise 3D interactive manipulations in VR environments and precise solid modelling in VR environments cannot be guaranteed. In this paper, constraints are incorporated into the VR environment for intuitive and precise solid modelling. A hierarchically structured constraint-based data model is developed to support solid modelling in the VR environment. Solid modelling in the VR environment is precisely performed in an intuitive manner through constraint-based manipulations. Constraint-based manipulations are accompanied with automatic constraint recognition and precise constraint satisfaction to establish the hierarchically structured constraint-based data model and are realized by allowable motions for precise 3D interactions in the VR environment. The allowable motions are represented as a mathematical matrix for conveniently deriving allowable motions from constraints. A procedure-based degree-of-freedom incorporation approach for 3D constraint solving is presented for deriving the allowable motions. A rule-based constraint recognition engine is developed for both constraint-based manipulations and implicitly incorporating constraints into the VR environment. A prototype system has been implemented for precise solid modelling in an intuitive manner through constraint-based manipulations in the VR environment.

Virtual reality (VR) provides a completely digital world of interaction which enables the users to modify, edit, and transform digital elements in a responsive way. Mixed reality (MR), which is the result of blending the digital world and the physical world together, brings new advancements and challenges to human, computer and environment interactions. This paper focuses on adapting the already-existing methods and tools in architecture to both VR and MR environments under sustainable architectural design domain. For this purpose, we benefit from the semantically enriched data platforms of Building information modelling (BIM) tools, the performance calculation functions of building energy simulation tools while transcending these data into VR and MR environments. In this way, we were able to merge these diverse data for the virtual design activity. Nine participants have already tested the initial prototype of MR-based only interaction environment in our previous study [1]. According to the feedbacks, the user interface and interaction mechanisms were updated and the environment was made accessible also in VR. These updates made four types of interactions possible in MR and VR: 1) MR environment using HoloLens with gestures, 2) MR environment using HoloLens with a clicker, 3) VR environment using HTC Vive with two controllers, and 4) HoloLens emulator with a mouse. All these interaction cases were tested by 21 architecture students in an in-house workshop. In this workshop, we collected data on presence, usability, and technology acceptance of these cases. Our results show that interaction in a VR environment is the most natural interaction type and the participants were eager to use both MR and VR environments instead of an emulator. To our best of knowledge, this is the first comparative study of a BIM-based architectural design medium in both VR and MR environments.

The impact of digital scents on behavioral health in a restorative virtual reality environment

ObjectiveEvaluation of the benefits of a virtual reality (VR) environment with a head-mounted display (HMD) for decision-making in liver surgery.BackgroundTraining in liver surgery involves appraising radiologic images and considering the patient’s clinical information. Accurate assessment of 2D-tomography images is complex and requires considerable experience, and often the images are divorced from the clinical information. We present a comprehensive and interactive tool for visualizing operation planning data in a VR environment using a head-mounted-display and compare it to 3D visualization and 2D-tomography.MethodsNinety medical students were randomized into three groups (1:1:1 ratio). All participants analyzed three liver surgery patient cases with increasing difficulty. The cases were analyzed using 2D-tomography data (group “2D”), a 3D visualization on a 2D display (group “3D”) or within a VR environment (group “VR”). The VR environment was displayed using the “Oculus Rift ™” HMD technology. Participants answered 11 questions on anatomy, tumor involvement and surgical decision-making and 18 evaluative questions (Likert scale).ResultsSum of correct answers were significantly higher in the 3D (7.1 ± 1.4, p < 0.001) and VR (7.1 ± 1.4, p < 0.001) groups than the 2D group (5.4 ± 1.4) while there was no difference between 3D and VR (p = 0.987). Times to answer in the 3D (6:44 ± 02:22 min, p < 0.001) and VR (6:24 ± 02:43 min, p < 0.001) groups were significantly faster than the 2D group (09:13 ± 03:10 min) while there was no difference between 3D and VR (p = 0.419). The VR environment was evaluated as most useful for identification of anatomic anomalies, risk and target structures and for the transfer of anatomical and pathological information to the intraoperative situation in the questionnaire.ConclusionsA VR environment with 3D visualization using a HMD is useful as a surgical training tool to accurately and quickly determine liver anatomy and tumor involvement in surgery.

Spatiotemporal gait deviations in a virtual reality environment

In this paper, we provide an approach for authenticating users in virtual reality (VR) environments by tracking the behavior of users as they perform goal-oriented tasks, such as throwing a ball at a target. With the pervasion of VR in mission-critical applications such as manufacturing, navigation, military training, education, and therapy, validating the identity of users using VR systems is becoming paramount to prevent tampering of the VR environments, and to ensure user safety. Unlike prior work, which uses PIN and pattern based passwords to authenticate users in VR environments, our approach authenticates users based on their natural interactions within the virtual space by matching the 3D trajectory of the dominant hand gesture controller in a display-based head-mounted VR system to a library of trajectories. To handle natural differences in wait times between multiple parts of an action such as picking a ball and throwing it, our matching approach uses a symmetric sum-squared distance between the nearest neighbors across the query and library trajectories. Our work enables seamless authentication without requiring the user to stop their activity and enter specific credentials, and can be used to continually validate the identity of the user. We conduct a pilot study with 14 subjects throwing a ball at a target in VR using the gesture controller and achieve a maximum accuracy of 92.86% by comparing to a library of 10 trajectories per subject, and 90.00% by comparing to 6 trajectories per subject.

Background: It is well established that regular participation in exercise and virtual reality (VR) environments are important tools for improving or maintaining human health and cognitive function. Objectives: This study examined the effects of acute exercise and VR environments on children’s memory function and exercise preference (i.e. cycling with or without the use of VR technology). Methods: Α 2×3 factorial design was adopted with two measures (pre, post) and three study groups. Forty-five healthy children aged 9 to 13 years (Mage = 10.91±1.24 years) voluntarily participated in the study. Participants were randomly assigned into three groups receiving different treatment: (1) an exercise+VR group that cycled for 15 min in a VR environment (forest path) combined with basic mathematical problem-solving tasks, (2) an exercise group that cycled for 15 min, and (3) a no-exercise group that sat in a specific place in a lab for 15 min (the control group). Before and after the acute exercise, all the groups completed the Sternberg Memory Task. Upon completion of the intervention, the two exercise groups completed measures of enjoyment, intention and attitudes towards cycling. The exercise+VR group also completed a scale capturing the VR’s usability. Results: The results show that the exercise group scored higher on Sternberg’s Memory Task (p .05) after the acute exercise treatment (post) than before it (pre). Similarly, the exercise+VR participants scored higher on the post-intervention memory task than did the exercise and control groups (p .05). Moreover, the exercise+VR group reported higher scores on enjoyment, intention and attitude towards cycling than the exercise group, but this difference was not statistically significant (p .05). Finally, the exercise+VR participants recorded high scores on the usability of the VR system during the acute exercise programme. Conclusions: These findings are in line with those of previous studies, underlining the important roles of exercise and VR environments on youths’ cognitive function.

This paper includes a research review in five bibliographic databases on using the application of virtual reality (VR) and augmented reality (AR) in physical and occupational therapy (POT). This literature review addresses five research questions and two sub‐research questions. A total of 36 relevant studies were selected in the review based on the defined keywords and inclusion‐exclusion criteria. The primary motivation for using the application of VR and AR in POT is that it is accurate, involves higher patient participation, and requires less therapy recovery time. The standard software tool used is the Unity 3D game engine, and the common device used is the Oculus Rift HMD. Various applications of VR and AR consist of different VR environments and AR contents used in POT. Post‐stroke rehabilitation, rehabilitation exercises, pain management, mental and behavioral disorders, and autism in children are the main aspects addressed through the VR and AR environments. Literature review indicates that questionnaires, interviews, and observation are the primary metrics for measuring therapy's effectiveness. The study's findings show positive results such as reduced treatment time, nervousness, pain, hospitalization period, making therapy enjoyable and encouraging, improved quality of life, and focus on using the application of VR and AR in POT. This review will be relevant to researchers, VR and AR application designers, doctors, and patients using the application of VR and AR in POT. Further research addressing multiple participants with clinical trials, adding new VR environments and AR content in VR and AR applications, including follow‐up sessions, and increasing training sessions while using the application of VR and AR in POT are recommended.

ContextCurrent data visualization interfaces predominantly rely on 2-D screens. However, the emergence of virtual reality (VR) devices capable of immersive data visualization has sparked interest in exploring their suitability for visualizing software development data. Despite this, there is a lack of detailed investigation into the effectiveness of VR devices specifically for interacting with software development data visualizations.ObjectiveOur objective is to investigate the following question: “How do VR devices compare to traditional screens in visualizing data about software development?” Specifically, we aim to assess the accuracy of conclusions derived from exploring visualizations for understanding the software development process, as well as the time required to reach these conclusions.MethodIn our controlled experiment, we recruited N=32 volunteers with diverse backgrounds. Participants interacted with similar data visualizations in both VR and traditional screen environments. For the traditional screen setup, we utilized a commercially available set of interactive dashboards based on Kibana, commonly used by Bitergia customers for data insights. In the VR environment, we designed a set of visualizations, tailored to provide an equivalent dataset within a virtual room. Participants answered questions related to software evolution processes, specifically code review and issue tracking, in both VR and traditional screen environments, for two projects. We conducted statistical analyses to compare the correctness of their answers and the time taken for each question.ResultsOur findings indicate that the correctness of answers in both environments is comparable. Regarding time spent, we observed similar durations, except for complex questions that required examining multiple interconnected visualizations. In such cases, participants in the VR environment were able to answer questions more quickly.ConclusionBased on our results, we conclude that VR immersion can be equally effective as traditional screen setups for understanding software development processes through visualization of relevant metrics in most scenarios. Moreover, VR may offer advantages in comprehending complex tasks that require navigating through multiple interconnected visualizations. However, further experimentation is necessary to validate and reinforce these conclusions.

Vision and Locomotion Combine to Drive Path Integration Sequences in Mouse Retrosplenial Cortex.

Stress is a common problem associated with poor physical and psychological health. Exposure to the natural environment is one method for reducing stress. The real and simulated natural environments have a restorative effect on stress reduction. In contrast to the real environment, simulated natural environments, such as virtual reality and 2D video, provide safer and more controllable exposure. Several studies on the restorative effects of the natural environment in virtual reality and 2D video have been conducted. However, the difference between the two in reducing stress must be clarified. This study was conducted to determine the effect of the simulated natural environments in virtual reality and 2D video and their differences in reducing stress. This study hypothesizes that both simulated natural environments in virtual reality and 2D video can reduce stress, but there is a difference between them in reducing stress. Fifty-three subjects were divided into two experimental groups: 2D video (n = 28) and virtual reality (n = 25). The results indicated that simulated natural environments in virtual reality and 2D video reduced stress. However, there was no difference between the two groups regarding stress reduction.

Claustrophobia is an anxiety disorder characterized by the fear of enclosed spaces. Although medication treatment can effectively control symptoms, the effects quickly disappear once medication is discontinued. Many studies have shown that combining psychotherapy and medication is more efficacious than solely using medication. However, the weaknesses of the traditional psychotherapy are that it is time-consuming and expensive. Alternatively, vivo exposure therapy is proposed in which anxiety is gradually triggered with stimuli. Targeting claustrophobia is diagnosed using the traditional method, and this study established virtual reality (VR) and augmented reality (AR) environments consistent with claustrophobic characteristics, comparing the two using an experimental process to examine whether VR and AR environments are equally capable of triggering anxiety in participants. This study further analysed the efficacies of VR and AR by measuring changes in participant's heart rates variability (HRV) and examining data from survey questionnaires. HRV results indicated that the proposed VR system and AR system were both able to trigger anxiety. Furthermore, the AR environment produced a stronger experience for the participants and caused physiological reactions more evident than those caused by the VR environment. Regarding the anxiety questionnaire, the participants suggested that their anxiety was significantly higher in the VR environment than in the AR environment.