Computer-generated Virtual Reality Research Articles

Healthcare Interventions for Children Using Nonimmersive Virtual Reality: A Mixed Methods Systematic Review

Nonimmersive virtual reality (NIVR), a computer-generated virtual reality experience wherein users are not fully immersed, has been increasingly used in pediatric healthcare. This study aimed to identify the effects of NIVR-based interventions for children. A mixed methods systematic review of relevant studies published until December 2023 was conducted. We included samples of healthy children and those with chronic conditions or disabilities, findings related to self-management or social skills, and the NIVR interventions applied. A convergent-integrated design was used for the synthesis. This review included 22 studies, of which 15 examined children having autism spectrum disorders. Utilizing NIVR was found to be effective in enhancing social skills. Participating in virtual communities with peers having similar conditions was determined to facilitate social support and identity exploration. Healthcare interventions using NIVR need to be explored further to improve self-management and social skills in children with various conditions.

Application of 360° virtual reality videos in the assessment of paranoia in schizophrenia patients: a pilot study.

Virtual Reality (VR) has been widely used in psychiatry, including psychotic disorders. The main advantage of VR is its high ecological validity and controllability of the virtual environment. Our main goal was to test whether, similarly to computer-generated VR, 360-degree videos are able to elicit a state of social paranoia in prone individuals. Sixteen schizophrenia patients and twenty-three healthy individuals were assessed using Leibowitz Social Anxiety Scale and additionally, in the patient group, the Positive and Negative Syndrome Scale (PANSS-6) and Peters Delusional Inventory (PDI) were used. The participants viewed four 360-degree videos with and without social content on a VR headset. Meanwhile, subjects' heart rate was measured continuously. After the exposure, both groups were assessed with Social State Paranoia Scale (SSPS) and asked about momentary anxiety and sense of presence. The schizophrenia patients reported higher momentary anxiety, although the results of SSPS did not differ significantly between groups. In the control group the heart rate decreased between first non-social and social video, whereas in the patient group it did not differ significantly. There was a significant correlation of paranoid ideation experienced on daily basis (PDI) and elicited in VR (SSPS) in the patient group. In conclusion, paranoid responses can be triggered in patients with schizophrenia by 360-degree videos.

Analgesic and Anxiolytic Effects of Virtual Reality During Minor Procedures in an Emergency Department: A Randomized Controlled Study

We aimed to assess the analgesic and anxiolytic efficacy of distraction, a nonpharmacologic intervention provided by 3-dimensional (3D) virtual reality (VR) compared with that provided by 2-dimensional (2D) VR during minor emergency department (ED) procedures. This randomized controlled study conducted in the ED of a teaching hospital included patients aged more than or equal to 18 years undergoing minor procedures. The patients watched the same computer-generated VR world either in 3D in a head-mounted display (intervention) or in 2D on a laptop screen (control). Our main outcomes were pain and anxiety during the procedure, assessed on a 100-mm visual analog scale. Secondary outcomes included the impression of telepresence in the computer-generated world assessed using the Igroup Presence Questionnaire, and the prevalence and intensity of cybersickness measured on a 100-mm visual analog scale. The final analysis included 117 patients. The differences in median procedural pain and anxiety levels between the 2D and 3D VR groups were not significant:-3 mm (95% confidence interval [CI]-14 to 8) and-4 mm (95% CI-15 to 3), respectively; the difference in telepresence was 2.0 point (95% CI 0 to 2.0), and the proportion difference of cybersickness was-4% (95% CI-22 to 14), with an intensity difference of-5 mm (95% CI-9 to 3). During minor procedures in adult patients in the ED, distraction by viewing a 3D virtual world in a head-mounted VR display did not result in lower average levels of procedural pain and anxiety than that by 2D viewing on a screen despite a higher sense of telepresence. There were no significant differences in the prevalence and intensity of cybersickness between the 2 groups.

Effectiveness of Computer-Generated Virtual Reality (VR) in Learning and Teaching Environments with Spatial Frameworks

In this paper, we highlight the benefits of using computer-generated VR in teaching instructional content that have spatial frameworks such as in science, technology, engineering, and mathematics (STEM) courses. Spatial ability scores were collected from a sample (N = 62) of undergraduate and graduate students. Students were required to complete an instructional tutorial in VR and computer desktop screening on DNA molecules, which included necessary information about DNA and nucleotide molecules. Students also completed a comprehensive test about the spatial structure of DNA and a feedback questionnaire. Results from the questionnaire showed media use and satisfaction to be significantly related. The results also showed a significant interaction between spatial ability levels (low, medium, and high) and media used on students’ spatial understanding of the DNA molecules. It may be concluded that VR visualization had a positive compensating impact on students with low spatial ability.

Exergaming for patients with metabolic syndrome?!

Due to the tremendous technical progress that has been made in recent years and the increased interest in using new technologies in sports and exercise, the effects of "exergaming" (exercise with video games and the use of an interactive computer-generated virtual reality) on human health have been investigated in numerous research projects. This systematic mini review analyzes the effects of regular exergaming in patients with components of metabolic syndrome. The review indicates that improvements in different variables, e.g., body mass index, body fat, glycemic control and blood lipid/lipoprotein levels, as well as blood pressure, can be achieved through regular exergaming. Future studies should examine whether exergaming can motivate patients with metabolic syndrome to engage in physical activity in the long term. Support from and (initial) supervision by health professionals (sports coaches, physiotherapists) are recommended to increase positive outcomes.

Verification of perception difference between actual space and VR space in car design

To evaluate a car’s design before its introduction to the market, automobile companies traditionally conduct customer surveys using clay models or real products. Recently, however, virtual reality (VR) has attracted significant attention as an efficient alternative to this costly and time-consuming practice. However, from the viewpoint of a customer’s intention to purchase, based on the design of the car, the differences between evaluations made using VR and by viewing an actual vehicle need to be clarified. In this study, the perception difference between actual space, VR space, and paper was verified with a randomized controlled trial involving four groups: (1) an actual car group, (2) a photographed VR group, (3) a computer-generated VR (CG VR) group, and (4) a paper group. By preparing the least expensive (paper) group, the usefulness of VR could be further clarified. The results showed that, whereas there is no perception difference for purchase intention and style attributes, there is a perception difference in terms of the factors underlying the purchase intention. The best way to convey the comfort of the interior space was CG VR, given that the size can be defined by data. Therefore, this was slightly advantageous over photograph-based VR, for which the interior size could not be defined. In addition, it became clear that it was very difficult to convey the amount of interior space using the paper-based method. These findings can help overcome the constraints of current design surveys and contribute to customer-oriented manufacturing.

Affective and Attentional States When Running in a Virtual Reality Environment.

Engaging in physical exercise in a virtual reality (VR) environment has been reported to improve physical effort and affective states. However, these conclusions might be influenced by experimental design factors, such as comparing VR environments against a non-VR environment without actively controlling for the presence of visual input in non-VR conditions. The present study addressed this issue to examine affective and attentional states in a virtual running task. Participants (n = 40), completed a 21 min run on a treadmill at 70% of Vmax. One group of participants ran in a computer-generated VR environment that included other virtual runners while another group ran while viewing neutral images. Participants in both conditions showed a pattern of reduced positive affect and increased tension during the run with a return to high positive affect after the run. In the VR condition, higher levels of immersive tendencies and attention/absorption in the virtual environment were associated with more positive affect after the run. In addition, participants in the VR condition focused attention more on external task-relevant stimuli and less to internal states than participants in the neutral images condition. However, the neutral images condition produced less negative affect and more enjoyment after the run than the VR condition. The finding suggest that the effects of exercising in a VR environment will depend on individual difference factors (e.g., attention/absorption in the virtual world) but it may not always be better than distracting attention away from exercise-related cues.

Profiling subjective symptoms and autonomic changes associated with cybersickness.

Our aim was to expand knowledge of cybersickness - a subtype of motion sickness provoked by immersion into a moving computer-generated virtual reality. Fourteen healthy subjects experienced a 15-min rollercoaster ride presented via a head-mounted display (Oculus Rift), for 3 consecutive days. Heart rate, respiration, finger and forehead skin conductance were measured during the experiment; this was complemented by a subjective nausea rating during the ride and by Motion Sickness Assessment Questionnaire before, immediately after and then 1, 2 and 3h post-ride. Physiological measurements were analysed in three dimensions: ride time, association with subjective nausea rating and experimental day. Forehead, and to a lesser extent finger phasic skin conductance activity showed a correlation with the reported nausea ratings, while alteration in other measured parameters were mostly related to autonomic arousal during the virtual ride onset. A significant habituation was observed in subjective symptom scores and in the duration of tolerated provocation. The latter increased from 7.0±1.3min on the first day to 12.0±2.5min on the third day (p<0.05); this was associated with a reduced slope of nausea rise from 1.3±0.3units/min on the first to 0.7±0.1units/min on the third day (p<0.01). Furthermore, habituation with repetitive exposure was also determined in the total symptom score post-ride: it fell from 1.6±0.1 on the first day to 1.2±0.1 on the third (p<0.001). We conclude that phasic changes of skin conductance on the forehead could be used to objectively quantify nausea; and that repetitive exposure to provocative VR content results in habituation.

Virtual Reality in the Age of Panoramas: Mapping Out Buildings, a Village, Capitals, and Hell

This essay follows a network of correspondences across media and technologies in nineteenth-century visual culture that developed alongside realism in literature and painting. The path they plot out at the intersection of panoramic literature, the diorama, and optical technology grants us insight into how notions of simulation we associate with computer-generated virtual reality coalesced in various combinations and perspectives during that era. The article notes the role played by the motif of the devil in that process, cross-section representations of urban dwellings, and stereoscopic tours of actual and virtual spaces. It aims to make the case that the thematic and topographic breadth of some Second-Empire photographic tours mapped out broad virtual territories, offering 3D immersion, extensive contiguity, and cross-referencing as a first step towards the seamless continuity of digital environments.

Flat-floored Air-lifted Platform: A New Method for Combining Behavior with Microscopy or Electrophysiology on Awake Freely Moving Rodents

It is widely acknowledged that the use of general anesthetics can undermine the relevance of electrophysiological or microscopical data obtained from a living animal’s brain. Moreover, the lengthy recovery from anesthesia limits the frequency of repeated recording/imaging episodes in longitudinal studies. Hence, new methods that would allow stable recordings from non-anesthetized behaving mice are expected to advance the fields of cellular and cognitive neurosciences. Existing solutions range from mere physical restraint to more sophisticated approaches, such as linear and spherical treadmills used in combination with computer-generated virtual reality. Here, a novel method is described where a head-fixed mouse can move around an air-lifted mobile homecage and explore its environment under stress-free conditions. This method allows researchers to perform behavioral tests (e.g., learning, habituation or novel object recognition) simultaneously with two-photon microscopic imaging and/or patch-clamp recordings, all combined in a single experiment. This video-article describes the use of the awake animal head fixation device (mobile homecage), demonstrates the procedures of animal habituation, and exemplifies a number of possible applications of the method.

Flat-floored Air-lifted Platform: A New Method for Combining Behavior with Microscopy or Electrophysiology on Awake Freely Moving Rodents

It is widely acknowledged that the use of general anesthetics can undermine the relevance of electrophysiological or microscopical data obtained from a living animal’s brain. Moreover, the lengthy recovery from anesthesia limits the frequency of repeated recording/imaging episodes in longitudinal studies. Hence, new methods that would allow stable recordings from non-anesthetized behaving mice are expected to advance the fields of cellular and cognitive neurosciences. Existing solutions range from mere physical restraint to more sophisticated approaches, such as linear and spherical treadmills used in combination with computer-generated virtual reality. Here, a novel method is described where a head-fixed mouse can move around an air-lifted mobile homecage and explore its environment under stress-free conditions. This method allows researchers to perform behavioral tests (e.g., learning, habituation or novel object recognition) simultaneously with two-photon microscopic imaging and/or patch-clamp recordings, all combined in a single experiment. This video-article describes the use of the awake animal head fixation device (mobile homecage), demonstrates the procedures of animal habituation, and exemplifies a number of possible applications of the method.

Dissimilar outcomes of apparently similar procedures as a challenge to clinical neurorehabilitation and basic research: When the same is not the same

In the study of the brain and how it adapts to changes or injury, researchers sometimes come across situations where apparently similar types of tests or training do not achieve similar outcome results. This is true, in particular, within the field of computer-based rehabilitation where paper-and-pencil tests and training is converted to computer. This paper raises the attention to the fact that supposedly similar settings may not, in fact, elicit similar results and caution therapists and researchers who work with rehabilitation of brain injury. The paper suggests that the underlying mechanisms behind this may be illuminated by using the REF (Reorganization of Elementary Functions) model and suggests that further research into the use of advanced technologies such as computer-generated virtual reality is required.

Computer-Generated Virtual Reality to Control Pain and Anxiety in Pediatric and Adult Burn Patients During Wound Dressing Changes

Changing daily wound dressings provokes a substantial amount of pain in patients with severe burn wounds. Pharmacological analgesics alone often are inadequate to solve this problem. This study explored whether immersive virtual reality (VR) can reduce the procedural pain and anxiety during an entire wound care session and compared VR to the effects of standard care and other distraction methods. Nineteen inpatients ages 8 to 65 years (mean, 30 years) with a mean TBSA of 7.1% (range, 0.5-21.5%) were studied using a within-subject design. Within 1 week of admission, standard care (no distraction), VR, or another self-chosen distraction method was administered during the wound dressing change. Each patient received the normal analgesic regimen. Pain was measured with visual analog thermometer scores, and anxiety was measured with the state-version of the Spielberger State Trait Anxiety Inventory. After comparing different distraction methods, only VR and television showed significant pain reductions during wound dressing changes. The effects of VR were superior, but not statistical significant, to that of television. Thirteen of 19 patients reported clinically meaningful (33% or greater) reductions in pain during VR distraction. No side effects were reported. No correlations were found between the reduction in pain ratings and patient variables like age, sex, duration of hospital stay, or percentage of (deep) burns. There was no significant reduction of anxiety ratings.

Optic flow dominates visual scene polarity in causing adaptive modification of locomotor trajectory

Locomotion and posture are influenced and controlled by vestibular, visual and somatosensory information. Optic flow and scene polarity are two characteristics of a visual scene that have been identified as being critical in how they affect perceived body orientation and self motion. The goal of this study was to determine the role of optic flow and visual scene polarity on adaptive modification in locomotor trajectory. An object is said to have visual polarity, or to be “visually polarized”, when it contains an identifiable principal axis with one end distinct from the other. Two computer-generated virtual reality scenes were shown to subjects during 20 min of treadmill walking. One scene was a highly polarized scene, while the other was composed of objects displayed in a non-polarized fashion. Both virtual scenes depicted constant rate self motion equivalent to walking counterclockwise around the perimeter of a room. Subjects performed Stepping Tests blindfolded before and after scene exposure to assess adaptive changes in locomotor trajectory. Subjects showed a significant difference in heading direction, between pre- and post-adaptation Stepping Tests, when exposed to either scene during treadmill walking. However, there was no significant difference in the subjects' heading direction between the two visual scene polarity conditions. Therefore, it was inferred from these data that optic flow has a greater role than visual polarity in influencing adaptive locomotor function.

Virtual Reality Hypnosis: A Case Report

This preliminary case report explored the use of hypnosis induced through a 3-dimensional, immersive, computer-generated virtual reality (VR) world as a means to control pain and anxiety in a patient with a severe burn injury. On hospitalization Day 40, after reports of uncontrollable pain and anxiety, the patient underwent hypnotic induction while immersed in a virtual world and received posthypnotic suggestions for decreased pain and anxiety during subsequent wound-care sessions. The patient’s pain and anxiety each dropped 40% after VR hypnosis on a Graphic Rating Scale for his Day 41 wound care. Pain dropped similar levels on Day 42 with an audio-only version of the intervention and then returned to baseline without intervention on Day 43.

Effect of Virtual Reality Graded Exposure on Heart Rate and Self-Reported Anxiety Levels of Performing Saxophonists

This study is an examination of the effect of computer-generated virtual reality graded exposure on the physiological and psychological responses of performing musicians. Eight university saxophone majors, five men and three women, participated in twelve 15- to 20-minute weekly practice sessions during which they were immersed in one of four different virtual environments designed to elicit various anxiety levels. Baseline heart rates and subjective measurements were taken prior to immersion and continued throughout the exposure period. In addition, heart rate and subjective measurements were recorded for three live performances given by each subject before beginning the virtual reality exposure and after completion of the sixth and the twelfth exposure sessions. Findings indicated that the virtual environments did elicit a sense of presence and may have provided the means for desensitization. Heart-rate readings and psychological indications of anxiety did not always correspond.

Flexible Endoscopy Simulators

Training in flexible endoscopy is becoming increasingly complex. In an effort to improve the efficiency of endoscopic education, physicians are turning to simulation technology to provide a platform for training away from the endoscopy suite. The concept of medical simulation is not new, but the recent addition of powerful computer-generated virtual reality simulation has revolutionized the field. These compact computers are now able to generate a simulated environment that not only mimics the movement of the endoscope, but also recreates the sounds of the endoscopy suite, the feel of the movement of the scope, the reaction of intestinal tissue, and the response of a patient experiencing discomfort. Within this life-like simulated environment, a wide variety of diagnostic and therapeutic endoscopic procedures can be performed. This article reviews the history of flexible endoscopy simulators and details the most advanced models currently available. The literature supporting the use of these simulators is also presented, and issues involving the incorporation of simulation technology into endoscopic education and credentialing are discussed.

Theta oscillations and human navigation: a magnetoencephalography study.

Magnetoencephalography (MEG) was used to study alpha and theta activity while subjects navigated through a computer-generated virtual reality town. The subjects were first allowed to explore the environment freely. They then had to navigate from a starting point to a destination, knowing that an obstruction would appear at one of several possible locations along the main route and force them to take a detour. Spatiotemporal analysis of the theta and alpha bands were performed (1) prior to the start of navigation, (2) from the start of navigation until the obstruction was encountered, (3) during the time subjects were contemplating a detour and were not navigating, and (4) from the resumption of navigation until the destination was reached. In all subjects, theta power was strongest during the two periods of navigation. The peak frequency of the oscillations was approximately 3.7 Hz. Control studies consisted of a motor task similar to that required for navigation, passive viewing of a tour through the same virtual reality town, and a mental concentration task. No consistent increases in theta power were seen in the MEG during any of the control tasks. The results suggest an association between theta rhythm and the performance of navigational tasks in humans.

Virtual reality and tactile augmentation in the treatment of spider phobia: a case report

This is the first case report to demonstrate the efficacy of immersive computer-generated virtual reality (VR) and mixed reality (touching real objects which patients also saw in VR) for the treatment of spider phobia. The subject was a 37-yr-old female with severe and incapacitating fear of spiders. Twelve weekly 1-hr sessions were conducted over a 3-month period. Outcome was assessed on measures of anxiety, avoidance, and changes in behavior toward real spiders. VR graded exposure therapy was successful for reducing fear of spiders, providing converging evidence for a growing literature showing the effectiveness of VR as a new medium for exposure therapy.

Virtual reality graded exposure in the treatment of acrophobia: A case report

This is the first case report to test the efficacy of computer-generated virtual reality (VR) for the treatment of acrophobia (fear of heights). The subject was a 19-year-old undergraduate student with a fear of heights, particularly of elevators. Twice weekly, sessions were conducted for 3 weeks, for a total of 5 sessions. Outcome was assessed on measures of anxiety, avoidance, attitude, distress, and included a behavioral avoidance test. VR graded exposure was successful in reducing fears of heights. VR graded exposure is proposed as a new medium for exposure therapy.