Cybersickness Symptoms Research Articles

Assessment of a Short, Focused Training to Reduce Symptoms of Cybersickness

Abstract Past reports have suggested that active visual training in virtual reality (VR) can reduce symptoms of cybersickness. Here, we adapted such a protocol to a computer-based version and compared it with a passive exposure control condition. We employed heart rate and other subjective predictors of cybersickness to try to predict the efficacy of the intervention as well as likelihood of drop out. While we found a significant decrease in heart rate across sessions, the intervention we employed did not appear to be effective at reducing cybersickness or dropout. However, a heart rate increase of 15.5 bpm from baseline, nausea self-report of 4.5 on a scale of 1–10, and dizziness self-report of 5.5 on a scale of 1–10 predicted an equal probability of experiment dropout, independent of whether participants were in the experimental or control intervention condition. Our findings suggest that a single immersion of visual training in VR or passive VR exposure may not be sufficient to provide adaptation for VR. At the same time, our findings bolster past reports suggesting the value of employing heart rate monitoring, rather than subjective reports, to monitor the onset of cybersickness.

Emotional and Cognitive Modulation of Cybersickness: The Role of Pain Catastrophizing and Body Awareness.

The goal was to investigate the influence of the tendency to catastrophize somatic symptoms and body awareness on motion-related sickness. Influences of emotional and cognitive-evaluative processes on the genesis of motion sickness or cybersickness have rarely been investigated. Brain imaging studies showed activation during cybersickness, resembling the pattern found for pain processing. Two aspects often investigated in this context are pain catastrophizing and body awareness. The present two studies investigated the relationship of motion-related sickness to two tendencies involved in pain processing: pain catastrophizing and body awareness. In the first study, 115 participants reported their motion sickness history, pain catastrophizing, and body awareness. In the second study, 40 participants were exposed to a virtual reality and reported their experience of cybersickness as well as their pain catastrophizing and body awareness. Pain catastrophizing was positively correlated to motion sickness history and cybersickness. Body awareness did not show a linear effect on motion sickness history or cybersickness. However, the interaction effect of pain catastrophizing and body awareness was significant in both studies. Pain catastrophizing seems to have a detrimental effect on cybersickness symptoms. Body awareness moderated the relationship in the sense that the combination of high pain catastrophizing and low body awareness lead to the highest sickness levels. Affective and cognitive modulation of cybersickness symptoms should be considered when exposing risk groups to motion-related adverse stimuli.

Comparison study of the use of 360-degree video and non-360-degree video simulation and cybersickness symptoms in undergraduate healthcare curricula.

The increasing use of emerging technologies in healthcare simulation, particularly virtual reality, has caused in increase in both use and misuse. It is the exploration and study of these types of technology that are key to their success-or failure-in simulation learning and teaching. Therefore, this exploratory study evaluated the most common perceived side effect of virtual reality, that of cybersickness. A total of n=60 undergraduate healthcare students participated in one of four identical learning outcome simulation events, using different simulation techniques. This study compared these four common simulation tools, high-fidelity manikin, standardised patient, video case study and 360-degree virtual reality video, and analysed the self-reported cybersickness symptoms. The results show that some virtual reality tools, in this case 360-degree video, are no more likely to provoke cybersickness symptoms than the other simulation methods used in this study. In addition, virtual reality is reported as less fatiguing than other methods of simulation learning. Virtual reality technologies may be a useful addition to the spectrum of simulation tools and techniques currently in use. This study suggests that there is no greater risk of cybersickness symptoms and this potential barrier to use is not borne out by this study.

Use of immersive virtual reality to assess episodic memory: A validation study in older adults

ABSTRACTVirtual reality (VR) allows for the creation of ecological environments that could be used for cognitive assessment and intervention. This study comprises two parts that describe and assess an immersive VR task, the Virtual Shop, which can be used to measure episodic memory. Part 1 addresses its applicability in healthy older adults by measuring presence, motivation, and cybersickness symptoms. Part 2 addresses its construct validity by investigating correlations between performance in the VR task and on a traditional experimental memory task, and by measuring whether the VR task is sensitive to age-related memory differences. Fifty-seven older and 20 younger adults were assessed in the Virtual Shop, in which they memorised and fetched 12 familiar items. Part 1 showed high levels of presence, higher levels of motivation for the VR than for the traditional task, and negligible cybersickness symptoms. Part 2 indicates that memory performance in the VR task is positively correlated with performance on a traditional memory task for both age groups, and age-related differences were found on the VR and traditional memory tasks. Thus, the use of VR is feasible in older adults and the Virtual Shop is a valid task to assess and train episodic memory in this population.

Anxiety Partially Mediates Cybersickness Symptoms in Immersive Virtual Reality Environments.

The use of virtual reality (VR) in psychological treatment is expected to increase. Cybersickness (CS) is a negative side effect of VR exposure and is associated with treatment dropout. This study aimed to investigate the following: (a) if gender differences in CS can be replicated, (b) if differences in anxiety and CS symptoms between patients and controls can be replicated, and (c) whether the relationship between exposure to VR and CS symptoms is mediated by anxiety. A sample (N = 170) of participants with different levels of psychosis liability was exposed to VR environments. CS and anxiety were assessed with self-report measures before and after the VR experiment. This study replicated gender differences in CS symptoms, most of which were present before exposure to VR. It also replicated findings that a significant correlation between anxiety and CS can be found in healthy individuals, but not in patients. In a VR environment, anxiety partially mediated CS symptoms, specifically nausea and disorientation. A partial explanation for the differences found between patients and controls may lie in a ceiling effect for the symptoms of CS. A second explanation may be the partial overlap between CS symptoms and physiological anxiety responses. CS symptoms reported at baseline cannot be explained by exposure to VR, but are related to anxiety. Caution is required when interpreting studies on both CS and anxiety, until the specificity in measurements has been improved. Since anxiety mediated the CS symptoms, CS is expected to decline during treatment together with the reduction of anxiety.

Two new virtual reality tasks for the assessment of spatial orientation Preliminary results of tolerability, sense of presence and usability.

Spatial orientation is a cognitive domain frequently impaired in Alzheimer's Disease and can be one of its earliest symptoms.Objective:This paper describes the results of tolerability, sense of presence and usability of two immersive virtual reality tasks for the assessment of spatial orientation, using VR headset in adults.Methods:31 healthy adults recruited from university and the local community performed two experimental immersive virtual reality tasks of spatial orientation: the SOIVET-Maze for the assessment of allocentric to egocentric spatial abilities and the SOIVET-Route for the assessment of spatial memory and landmark recognition. Participants completed questionnaires about sense of presence, cybersickness symptoms, technology use profile and motion sickness history. Usability measures were assessed by spontaneous feedback from participants.Results:All participants were able to understand the task instructions and how to interact with the system. Both tasks seemed to induce a strong sense of presence, as assessed by the Witmer and Singer Presence Questionnaires (M=128 and 143 for SOIVET-Maze and SOIVET-Route, respectively). The SOIVET-Route had a small numeric advantage over the SOIVET-Maze tolerability scores assessed by the Cybersickness Questionnaire (M=4.19, SD=5.576 and M=3.52, SD=6.418 for SOIVET-Maze and SOIVET-Route respectively). Also, there were no drop-outs on the SOIVET-Route due to tolerability issues, unlike the SOIVET-Maze, which had two drop-outs. However, this difference was not statistically significant (Z= -.901, p= 0.368, Wilcoxon signed-rank test).

Effects of visual flow direction on signs and symptoms of cybersickness.

Our objective was to assess the influence of visual flow direction on physiological changes and symptoms elicited by cybersickness. Twelve healthy subjects (6 male and 6 female) were exposed to a 15-min virtual ride on a rollercoaster on two different days in a counterbalanced manner, such half of participants were facing forward during the first ride while another half was facing backward. Forehead skin conductance, heart rate and HRV parameters (SDRR, RMSSD) were collected as objective measures; subjective symptoms were assessed with the Motion Sickness Assessment Questioner immediately after exposure. We found that while nausea ratings at which participants terminated the experiment did not differ between forward/backward rides, the mean ride tolerance time was significantly longer during reverse ride compared to forward ride (6.1±0.4 vs 5.0±0.5 min, respectively, p = 0.01, η2 = 0.45). Analysis of HRV parameters revealed significant reduction in both RMSSD (p = 0.02, t = 2.62, η2 = 0.43) and SDRR (p = 0.01, t = 2.90, η2 = 0.45) in the forward ride; no such changes were found in the backward ride. We also found that amplitude of phasic changes in forehead skin conductance increased significantly in both ride directions. This increase however was significantly lower (p<0.05) in backward ride when compared to the forward ride. When assessed immediately post-ride, subjects reported significantly lower (p = 0.04) subjective symptom intensity after the reverse ride compared to the forward ride. We conclude that the direction of visual flow has a significant effect on the symptoms reported by the subjects and on the physiological changes during cybersickness.

The Immersive Virtual Reality Experience: A Typology of Users Revealed Through Multiple Correspondence Analysis Combined with Cluster Analysis Technique.

Immersive virtual reality is thought to be advantageous by leading to higher levels of presence. However, and despite users getting actively involved in immersive three-dimensional virtual environments that incorporate sound and motion, there are individual factors, such as age, video game knowledge, and the predisposition to immersion, that may be associated with the quality of virtual reality experience. Moreover, one particular concern for users engaged in immersive virtual reality environments (VREs) is the possibility of side effects, such as cybersickness. The literature suggests that at least 60% of virtual reality users report having felt symptoms of cybersickness, which reduces the quality of the virtual reality experience. The aim of this study was thus to profile the right user to be involved in a VRE through head-mounted display. To examine which user characteristics are associated with the most effective virtual reality experience (lower cybersickness), a multiple correspondence analysis combined with cluster analysis technique was performed. Results revealed three distinct profiles, showing that the PC gamer profile is more associated with higher levels of virtual reality effectiveness, that is, higher predisposition to be immersed and reduced cybersickness symptoms in the VRE than console gamer and nongamer. These findings can be a useful orientation in clinical practice and future research as they help identify which users are more predisposed to benefit from immersive VREs.

Effects of Displays on Visually Controlled Task Performance in Three-Dimensional Virtual Reality Environment

This study aims to evaluate three commercial virtual reality VR display devices on the market via a 3D Fitts's task. In addition, a symptom questionnaire was used to assess the severity of cybersickness symptoms induced by these displays. Ten participants performed repetitive pointing tasks over different conditions of varying display devices, movement directions, and indices of difficulty. On the basis of the results, the projection display obtained the best task performance with the lowest movement time and the highest throughput. It had the least symptoms among the three display devices. The HMD gave the worst results in all criteria. The 3D TV could be considered as good as the projection display in task performance but induced slight level of discomfort, fatigue, and eyestrain. These findings not only provided an initial understanding of differences between the 3D TV and the other two familiar display devices in human performance when interacting within a 3D VE but also pointed a direction to effectively improve future VR display technique.

Virtual reality as a screening tool for sports concussion in adolescents

Primary objective: There is controversy surrounding the cognitive effects of sports concussion. This study aimed to verify whether the technique of virtual reality could aid in the identification of attention and inhibition deficits in adolescents.Study design: A prospective design was used to assess 25 sports-concussed and 25 non-sports-concussed adolescents enrolled in a sport and education programme.Methods and procedures: Participants were evaluated in immersive virtual reality via ClinicaVR: Classroom-CPT and in real life via the traditional VIGIL-CPT.Main outcomes and results: The neuropsychological assessment using virtual reality showed greater sensitivity to the subtle effects of sports concussion compared to the traditional test, which showed no difference between groups. The results also demonstrated that the sports concussion group reported more symptoms of cybersickness and more intense cybersickness than the control group.Conclusions: Sports concussion was associated with subtle deficits in attention and inhibition. However, further studies are needed to support these results.

Simulator Sickness Questionnaire: tradução e adaptação transcultural

Contexto: O estudo de cybersickness, sintomas desconfortáveis relacionados à interação em ambientes virtuais, é importante para a implementação de melhorias destes, para ajudar a preservar o bem-estar dos usuários e reduzir o abandono às exposições virtuais. Usar um instrumento adequado para identificar e mensurar os sintomas de cybersickness, de forma padronizada, pode contribuir para essa finalidade. Objetivo: Este estudo tem como objetivo apresentar as etapas de tradução e adaptação para a língua portuguesa do instrumento Simulator Sickness Questionnaire, que mede os sintomas de cybersickness. Métodos: Três traduções e retrotraduções foram realizadas por avaliadores independentes; realizaram-se a equivalência semântica e a avaliação das versões, sendo elaborada uma versão síntese. Os comentários dos participantes sobre a versão preliminar do questionário foram examinados. Resultados: Foi construída a versão brasileira preliminar do questionário. Verificou-se que a maioria dos participantes entendeu as descrições dos sintomas expostas no questionário em português. Conclusão: A utilização de três versões de tradução e retrotradução, discussão sobre a versão síntese e a interlocução com a população-alvo proporcionaram viabilidade ao processo de equivalência semântica da versão final brasileira.

Using a Virtual Reality System to Study Balance and Walking in a Virtual Outdoor Environment: APilot Study

Falls and fall-related injuries are a major problem for elderly persons. Most falls occur during walking and turning, and the risk of falling increases when attention is diverted to something besides walking. It is often difficult to standardize methods for testing balance and fall tendency in a clinically relevant setting. We describe the development of a system using a virtual environment (VE) to assess how attention demanding and unexpected events influence a person's capacity to control balance and movement. The hardware in the system consists of a head-mounted display (HMD), a magnetic tracker system, and two SGI computers. The software consists of the image generation of the VE and the management and visualization of motion tracking data. In a preliminary pilot study eight subjects (age 23-80) participated. Each subject walked on a normal floor and was visually presented a familiar outdoor environment in the HMD. They were exposed to different unexpected events, such as a virtual snowfall and tilting of the VE. Disturbances of balance and walking patterns such as changes in speed, stride length and balance reactions like slipping were observed. Two subjects experienced symptoms of cyber sickness with a SSQ score above 25 points. Walking with sensors only did not affect walking time, but in VE the subjects generally walked more slowly. Virtual tilting of the environment had an impact on balance performance during walking. This effect was not observed while the test subjects were walking in a virtual snowfall. The model needs further development but may hold a potential for clinical use.

High sensitivity to multisensory conflicts in agoraphobia exhibited by virtual reality

The primary aim of this study was to evaluate the effect of auditory feedback in a VR system planned for clinical use and to address the different factors that should be taken into account in building a bimodal virtual environment (VE). We conducted an experiment in which we assessed spatial performances in agoraphobic patients and normal subjects comparing two kinds of VEs, visual alone (Vis) and auditory–visual (AVis), during separate sessions. Subjects were equipped with a head-mounted display coupled with an electromagnetic sensor system and immersed in a virtual town. Their task was to locate different landmarks and become familiar with the town. In the AVis condition subjects were equipped with the head-mounted display and headphones, which delivered a soundscape updated in real-time according to their movement in the virtual town. While general performances remained comparable across the conditions, the reported feeling of immersion was more compelling in the AVis environment. However, patients exhibited more cybersickness symptoms in this condition. The result of this study points to the multisensory integration deficit of agoraphobic patients and underline the need for further research on multimodal VR systems for clinical use.

Quantifying Scene Movement with ‘Spatial Velocity’ and its Effects on Cybersickness

Viewing wide field-of-view scene movement with a Virtual Reality (VR) display can cause symptoms of cybersickness (e.g., nausea and headache). It has been known that cybersickness is a type of vection-induced motion sickness. Since vection is associated with the perception of moving scene, two studies have been conducted to investigate the effects of different scene movements on levels of cybersickness. The velocity and complexity of the scene movements were quantified by a previously reported metric called ‘spatial velocity (SV)’ while the levels of cybersickness were measured in terms of nausea ratings and Simulator Sickness Questionnaire (SSQ) scores. Results showed that in both experiments, both the nausea ratings and the SSQ total sickness scores increased significantly with increasing SV in the dominant axes of scene movement. Potential uses of the SV metric for formulating a CyberSickness Dose Value (CSDV) are discussed.