Game-based Virtual Reality Research Articles

Effect of a game-based virtual reality phone application on tracheostomy care education for nursing students: A randomized controlled trial

BackgroundA game-based virtual reality phone application is used as a simulation to teach psychomotor skills in nursing education. ObjectiveThis study aims at determining the effect of a game-based virtual reality phone application on tracheostomy care education for nursing students. DesignSingle-blind randomized controlled trial conducted from March–April 2017. SettingDepartment of Nursing, Faculty of Health Sciences, Central Anatolia of Turkey. ParticipantsA total of 86 first-year nursing students registered in Fundamentals of Nursing-II were included in this study. The students were divided at random into two groups, control (n = 43) and experimental (n = 43). MethodThe data were collected with an informative features form, a tracheostomy care knowledge test and skill checklists, and a performance assessment form. The control group commenced the study first so that the students did not affect each other. After the students completed the theoretical class, laboratory class, and small group study, they had their knowledge test and skills evaluation. The application featured tracheostomy care and was designed in support of formal education. It was uploaded to the mobile phones of the experimental group at a different phase of the study from the control group. After the experimental group made use of this application for seven days, their last knowledge test and skills evaluation were conducted. ResultsThe results of this study determined that the suctioning a tracheostomy tube and peristomal skin care average final test scores of the students in the experiment group were higher than the average scores of the students in the control group; this was statistically significant (p = 0.017, p = 0.003). ConclusionThe game-based virtual reality phone application was effective in teaching the skill of suctioning a tracheostomy tube for nursing students in the short term, and it is recommended that this application be used in psychomotor skill training.

Mirror Therapy Using Gesture Recognition for Upper Limb Function, Neck Discomfort, and Quality of Life After Chronic Stroke: A Single-Blind Randomized Controlled Trial.

BackgroundMirror therapy for stroke patients was reported to be effective in improving upper-extremity motor function and daily life activity performance. In addition, game-based virtual reality can be realized using a gesture recognition (GR) device, and various tasks can be presented. Therefore, this study investigated changes in upper-extremity motor function, quality of life, and neck discomfort when using a GR device for mirror therapy to observe the upper extremities reflected in the mirror.Material/MethodsA total of 36 subjects with chronic stroke were randomly divided into 3 groups: GR mirror therapy (n=12), conventional mirror therapy (n=12), and control (n=12) groups. The GR therapy group performed 3D motion input device-based mirror therapy, the conventional mirror therapy group underwent general mirror therapy, and the control group underwent sham therapy. Each group underwent 15 (30 min/d) intervention sessions (3 d/wk for 5 weeks). All subjects were assessed by manual function test, neck discomfort score, and Short-Form 8 in pre- and post-test.ResultsUpper-extremity function, depression, and quality of life in the GR mirror therapy group were significantly better than in the control group. The changes of neck discomfort in the conventional mirror therapy and control groups were significantly greater than in the GR mirror therapy group.ConclusionsWe found that GR device-based mirror therapy is an intervention that improves upper-extremity function, neck discomfort, and quality of life in patients with chronic stroke.

Effects of a Game-Based Virtual Reality Video Capture Training Program Plus Occupational Therapy on Manual Dexterity in Patients with Multiple Sclerosis: A Randomized Controlled Trial.

Neurorehabilitation is a fundamental aspect in the treatment approach for multiple sclerosis (MS), in which new technologies have gained popularity, especially the use of virtual reality (VR). The aim of this paper is to analyze an occupational therapy (OT) intervention compared with OT + VR (OT + VR) on the manual dexterity of patients with MS. 26 MS subjects were initially recruited from an MS patient association and randomized into two groups. The OT group received 20 conventional OT sessions distributed in two sessions per week. The OT + VR group received 20 sessions of VR interventions, twice weekly and lasting 30 minutes, consisting of VR games accessed via the online web page motiongamingconsole.com, in addition to the conventional OT sessions. Pre- and postintervention assessments were based on the Purdue Pegboard Test, the Jebsen-Taylor Hand Function Test, and the Grooved Pegboard Test. Clinical improvements were found regarding the precision of movements, the execution times, and the efficiency of certain functional tasks in the Purdue Pegboard Test and Jebsen-Taylor Hand Function Test tests in the OT + VR group. Although significant differences were not found in the manual dexterity between the OT and OT + VR groups, improvements were found regarding the precision and effectiveness of certain functional tasks.

A Critical Review of the Use of Virtual Reality in Construction Engineering Education and Training.

Virtual Reality (VR) has been rapidly recognized and implemented in construction engineering education and training (CEET) in recent years due to its benefits of providing an engaging and immersive environment. The objective of this review is to critically collect and analyze the VR applications in CEET, aiming at all VR-related journal papers published from 1997 to 2017. The review follows a three-stage analysis on VR technologies, applications and future directions through a systematic analysis. It is found that the VR technologies adopted for CEET evolve over time, from desktop-based VR, immersive VR, 3D game-based VR, to Building Information Modelling (BIM)-enabled VR. A sibling technology, Augmented Reality (AR), for CEET adoptions has also emerged in recent years. These technologies have been applied in architecture and design visualization, construction health and safety training, equipment and operational task training, as well as structural analysis. Future research directions, including the integration of VR with emerging education paradigms and visualization technologies, have also been provided. The findings are useful for both researchers and educators to usefully integrate VR in their education and training programs to improve the training performance.

Game-Based Virtual Reality Canoe Paddling Training to Improve Postural Balance and Upper Extremity Function: A Preliminary Randomized Controlled Study of 30 Patients with Subacute Stroke.

BackgroundVirtual reality (VR) training with motion-controlled console games can be incorporated into stroke rehabilitation programs. The use of a variety of gaming software can provide the patient with an opportunity to perform activities that are exciting, entertaining, and that may not be feasible in clinical environments. The aim of this preliminary randomized controlled study was to investigate the effects of game-based VR canoe paddling training, when combined with conventional physical rehabilitation programs, on postural balance and upper extremity function in 30 patients with subacute stroke.Material/MethodsThirty patients, who were within six months following the diagnosis of stroke, were randomly allocated to either the experimental group (n=15) or the control group (n=15). All participants participated in a conventional rehabilitation program. Also, the experimental group (n=15) performed the VR canoe paddling training for 30 minutes each day, three times per week, for five weeks. After five weeks, outcomes of changes in postural balance and upper extremity function were evaluated and compared between the two groups.ResultsAt five weeks, postural balance and upper extremity function showed significant improvements in both patients groups when compared with the baseline measurements (p<0.05). However, postural balance and upper extremity function were significantly improved in the experimental group when compared with the control group (p<0.05).ConclusionsGame-based VR canoe paddling training is an effective rehabilitation therapy that enhances postural balance and upper extremity function in patients with subacute stroke when combined with conventional physical rehabilitation programs.

Feasibility of incorporating functionally relevant virtual rehabilitation in sub-acute stroke care: perception of patients and clinicians

Purpose: To determine user satisfaction and safety of incorporating a low-cost virtual rehabilitation intervention as an adjunctive therapeutic option for cognitive-motor upper limb rehabilitation in individuals with sub-acute stroke.Methods: A low-cost upper limb virtual rehabilitation application incorporating realistic functionally-relevant unimanual and bimanual tasks, specifically designed for cognitive-motor rehabilitation was developed for patients with sub-acute stroke. Clinicians and individuals with stroke interacted with the intervention for 15–20 or 20–45 minutes, respectively. The study had a mixed-methods convergent parallel design that included a focus group interview with clinicians working in a stroke program and semi-structured interviews and standardized assessments (Borg Perceived Exertion Scale, Short Feedback Questionnaire) for participants with sub-acute stroke undergoing rehabilitation. The occurrence of adverse events was also noted.Results: Three main themes emerged from the clinician focus group and patient interviews: Perceived usefulness in rehabilitation, satisfaction with the virtual reality intervention and aspects to improve. All clinicians and the majority of participants with stroke were highly satisfied with the intervention and perceived its usefulness to decrease arm motor impairment during functional tasks. No participants experienced major adverse events.Conclusions: Incorporation of this type of functional activity game-based virtual reality intervention in the sub-acute phase of rehabilitation represents a way to transfer skills learned early in the clinical setting to real world situations. This type of intervention may lead to better integration of the upper limb into everyday activities.Implications for Rehabilitation• Use of a cognitive-motor low-cost virtual reality intervention designed to remediate arm motor impairments in sub-acute stroke is feasible, safe and perceived as useful by therapists and patients for stroke rehabilitation. • Input from end-users (therapists and individuals with stroke) is critical for the development and implementation of a virtual reality intervention.

Mobile Game-based Virtual Reality Program for Upper Extremity Stroke Rehabilitation.

Stroke rehabilitation requires repetitive, intensive, goal-oriented therapy. Virtual reality (VR) has the potential to satisfy these requirements. Game-based therapy can promote patients' engagement in rehabilitation therapy as a more interesting and a motivating tool. Mobile devices such as smartphones and tablet PCs can provide personalized home-based therapy with interactive communication between patients and clinicians. In this study, a mobile VR upper extremity rehabilitation program using game applications was developed. The findings from the study show that the mobile game-based VR program effectively promotes upper extremity recovery in patients with stroke. In addition, patients completed two weeks of treatment using the program without adverse effects and were generally satisfied with the program. This mobile game-based VR upper extremity rehabilitation program can substitute for some parts of the conventional therapy that are delivered one-on-one by an occupational therapist. This time-efficient, easy to implement, and clinically effective program would be a good candidate tool for tele-rehabilitation for upper extremity recovery in patients with stroke. Patients and therapists can collaborate remotely through these e-health rehabilitation programs while reducing economic and social costs.

Mobile Game-based Virtual Reality Program for Upper Extremity Stroke Rehabilitation

Mobile Game-based Virtual Reality Program for Upper Extremity Stroke Rehabilitation

Validation of reaching in a virtual environment in typically developing children and children with mild unilateral cerebral palsy.

To compare three reaching movements made in two planes between a low-cost, game-based virtual reality and a matched physical environment in typically developing children and children with cerebral palsy (CP). To determine if differences in kinematics are related to sensory deficits. An observational study in which 27 children (typically developing, n=17, mean age 13y, [SD] 2y 2mo, range 9y 3mo-17y 2mo; CP, n=10, mean age 13y 8mo, [SD] 1y 8mo, range 11y 1mo-17y 1mo, Manual Ability Classification System levels I-II) performed 15 trials of threegestures in each of a virtual reality and a matched physical environment. Upper-limb and trunk kinematics were recorded using an electromagnetic system (G4, Polhemus, six markers, 120Hz). Compared to the physical environment, movements in virtual reality made by typically developing children were slower (p=0.002), and involved less trunk flexion (p=0.002) and rotation (p=0.026). Children with CP had more curved trajectories (p=0.005) and used less trunk flexion (p=0.003) and rotation (p=0.005). Elbow and shoulder kinematics differed from 2.8% to 155.4% between environments in both groups. Between groups, there were small, clinically insignificant differences with only the vertical gesture being longer in typically developing children. Children with CP who had greater tactile impairment used more trunk displacement. Clinicians and researchers need to be aware of differences in movement variables when setting goals or designing protocols for improving reaching in children with CP using low-cost, game-based virtual reality systems. Upper-limb kinematics differed in each group when reaching in physical versus virtual environments. There were small differences in movements made by children with mild unilateral cerebral palsy (CP) compared to typically developing children. Differences in reaching kinematics should be considered when goal setting using virtual reality interventions for children with mild unilateral CP.

Recent Developments in Game-Based Virtual Reality Educational Laboratories Using the Microsoft Kinect

Virtual Reality (VR) is a well-known concept and has been proven to be beneficial in various areas. However, several disadvantages inherent in VR prevent its broad deployment in the educational arena. These limitations include non-realistic representation, lack of customizability and flexibility, financial feasibility, physical and psychological discomforts of the users, simulator sickness, etc. In this paper, an innovative method that uses the Microsoft Kinect as an essential component for developing game-based VR educational laboratories is presented. This technique addresses three different aspects. First, it represents an efficient method for creating the VE using the Kinect as a measuring tool. Second, the Kinect is employed as a substitute DAQ system for acquiring range data and tracking the motion of objects of interest. At last, the Kinect serves as a novel human-computer interface for tracking the users’ entire body motion and recognizing their voices. Using the method described here, three major aspects of educational VR development can be accomplished with an inexpensive and commercially available Kinect.

Using Game-Based Virtual Reality with Haptics for Skill Acquisition

BackgroundNurse educators are challenged to find innovative methods to help nursing students develop and remember fundamental skills while ensuring patient safety. Virtual reality (VR) headgear and custom haptic technology combined with game-based learning principles may provide an innovative approach to promoting mastery learning and retention. MethodThis mixed methods pilot study explored the usability of, and user reaction to, a game-based VR system designed to practice urinary catheterization. Time on task and number of procedures completed in one hour were compared with subjects who practiced traditionally, using a task trainer with faculty oversight. Follow-up skill demonstration was compared two weeks after the practice session. ResultsSubjects (n = 20) rated usability of the VR system favorably; they also rated practicing catheter insertion this way as highly engaging and enjoyable. Subjects using the VR system spent more time practicing (p = .001) and completed more procedures in 1 hour than students who practiced traditionally (p < .001). Follow-up skill demonstration pass rates between groups were identical at 2 weeks. ConclusionPracticing nursing skills using game-based VR may be an effective way to promote mastery learning and retention.

Doing textiles experiments in game-based virtual reality

PurposeThe purpose of this paper is to discuss the use of stereoscopic virtual technology in textile and fashion studies in particular to the area of chemical experiment. The development of a designed virtual platform, called Stereoscopic Chemical Laboratory (SCL), is introduced.Design/methodology/approachTo implement the suggested educational approaches of SCL, a set of teaching and learning materials with emphasis on the application methods was revised from the existing subjects. The architecture of SCL includes building of virtual objects with the Autodesk software Maya and designing of interactivity by using Unity, a game engine system. Prototype version of the SCL has been passed to selected academic colleagues and students for further evaluation and application feedback.FindingsTextile students can conduct laboratory experiments associated with coloration and finishing of textile technologies in a stereoscopic 3D and multisensory laboratory, and hence enhance their learning experience. With the use of SCL, students can learn relevant experiment tools, experimental processes, procedures, and safety and health precautions.Originality/valueThere is very limited educational or training approach in applying stereoscopic virtual reality in teaching activities. In the area of textile experiment, the authors could say it is virtual and does not exist in current research domains.

Mobile game-based virtual reality rehabilitation program for upper limb dysfunction after ischemic stroke.

Virtual reality (VR) has the potential to provide intensive, repetitive, and task-oriented training, and game-based therapy can enhance patients' motivation and enjoyment. The objective of the present study was to develop a mobile game-based upper extremity VR program for patients who have experienced stroke, and to evaluate the feasibility and effectiveness of the program. This randomized, double-blind, controlled trial included 24 patients with ischemic stroke. The intervention group (n = 12) received 30 min of conventional occupational therapy (OT) and 30 min of the mobile upper extremity rehabilitation program using a smartphone and a tablet PC (MoU-Rehab). The controls (n = 12) received conventional OT alone for 1 h per day. Rehabilitation consisted of 10 sessions of therapy, 5 days per week, for 2 weeks. The outcome measures (Fugl-Meyer Assessment of the upper extremity [FMA-UE], Brunnström stage [B-stage] for the arm and the hand, manual muscle testing [MMT], modified Barthel index [MBI], EuroQol-5 Dimension [EQ-5D], and Beck Depression Inventory [BDI]) were assessed at the beginning and end of treatment, and at 1 month. User satisfaction was evaluated by a questionnaire. A greater improvement in the FMA-UE, B-stage, and MMT was found after treatment with the MoU-Rehab than with conventional therapy. The extent of improvements in the MBI, EQ-5D, and BDI was not significantly different between the two groups. Patients in the experimental group completed the 2-weeks treatment without adverse effects, and they were generally satisfied with MoU-Rehab. This mobile game-based VR rehabilitation program appears to be feasible and effective for promoting upper limb recovery after ischemic stroke.

The effects of game-based virtual reality movement therapy plus mental practice on upper extremity function in chronic stroke patients with hemiparesis: a randomized controlled trial.

[Purpose] The purpose of this study was to investigate the effects of game-based virtual reality movement therapy plus mental practice on upper extremity function in chronic stroke patients with hemiparesis. [Subjects] The subjects were chronic stroke patients with hemiparesis. [Methods] Thirty subjects were randomly assigned to either the control group or experimental group. All subjects received 20 sessions (5 days in a week) of virtual reality movement therapy using the Nintendo Wii. In addition to Wii-based virtual reality movement therapy, experimental group subjects performed mental practice consisting of 5 minutes of relaxation, Wii games imagination, and normalization phases before the beginning of Wii games. To compare the two groups, the upper extremity subtest of the Fugl-Meyer Assessment, Box and Block Test, and quality of movement subscale of the Motor Activity Log were performed. [Results] Both groups showed statistically significant improvement in the Fugl-Meyer Assessment, Box and Block Test, and quality of the movement subscale of Motor Activity Log after the interventions. Also, there were significant differences in the Fugl-Meyer Assessment, Box and Block Test, and quality of movement subscale of the Motor Activity Log between the two groups. [Conclusion] Game-based virtual reality movement therapy alone may be helpful to improve functional recovery of the upper extremity, but the addition of MP produces a lager improvement.

Canoe game-based virtual reality training to improve trunk postural stability, balance, and upper limb motor function in subacute stroke patients: a randomized controlled pilot study.

[Purpose] This study was aimed at investigating the preliminary therapeutic efficacy and usefulness of canoe game-based virtual reality training for stroke patients. [Subjects and Methods] Ten stroke patients were randomly assigned to an experimental group (EG; n=5) or a control group (CG; n=5). Patients in both groups participated in a conventional rehabilitation program, but those in the EG additionally participated in a 30-min canoe game-based virtual reality training program 3 days a week for 4 weeks. Therapeutic efficacy was assessed based on trunk postural stability, balance, and upper limb motor function. In addition, the usefulness of canoe game-based virtual reality training was assessed in the EG and therapist group (TG; n=20), which consisted of physical and occupational therapists, by using the System Usability Scale (SUS). [Results] Improvements in trunk postural stability, balance, and upper limb motor function were observed in the EG and CG, but were greater in the EG. The mean SUS scores in the EG and TG were 71 ± 5.2 and 74.2 ± 4.8, respectively. [Conclusion] Canoe game-based virtual reality training is an acceptable and effective intervention for improving trunk postural stability, balance, and upper limb motor function in stroke patients.

Effects of game-based virtual reality on health-related quality of life in chronic stroke patients: A randomized, controlled study

In the present study, we aimed to determine whether game-based virtual reality (VR) rehabilitation, combined with occupational therapy (OT), could improve health-related quality of life, depression, and upper extremity function. We recruited 35 patients with chronic hemiparetic stroke, and these participants were randomized into groups that underwent VR rehabilitation plus conventional OT, or the same amount of conventional OT alone, for 20 sessions over 4 weeks. Compared to baseline, the VR rehabilitation plus OT group exhibited significantly improved role limitation due to emotional problems (p=0.047). Compared to baseline, both groups also exhibited significantly improved depression (p=0.017) and upper extremity function (p=0.001), although the inter-group differences were not significant. However, a significant inter-group difference was observed for role limitation due to physical problems (p=0.031). Our results indicate that game-based VR rehabilitation has specific effects on health-related quality of life, depression, and upper extremity function among patients with chronic hemiparetic stroke.

Game-Based Virtual Reality Training Improves Sitting Balance after Spinal Cord Injury: A Single-Blinded, Randomized Controlled Trial

Game-Based Virtual Reality Training Improves Sitting Balance after Spinal Cord Injury: A Single-Blinded, Randomized Controlled Trial

Virtual reality game-based therapy for treatment of postural and co-ordination abnormalities secondary to TBI: A pilot study

Primary objective: The study objective was to test the efficacy of game-based virtual reality (VR) therapy as a mean of correcting postural and co-ordination abnormalities in individuals with traumatic brain injury (TBI). Therapy was done with interactive customized VR games and scenarios, utilizing an Xbox Kinect sensor.Research design: The study was a pilot project using the structure of a phase II clinical trial.Methods and procedures: Fifteen participants with mild-to-moderate chronic TBI-related balance and motor co-ordination impairments participated in 15 sessions, each lasting ∼50–55 minutes, scheduled 2–3 times a week over 5–6 consecutive weeks. Participants were evaluated at baseline, immediately after the final session and in a 1-month follow-up with a battery of clinical tests (measuring postural stability, gait and co-ordination) and movement performance parameters. Movement parameters included arm–leg co-ordination, dynamic stability and arm precision, calculated from kinematic data recorded with Xbox Kinect sensor.Results: Following therapy, most participants improved their static and dynamic postural stability, gait and arm movements. These effects persisted over the retention interval.Conclusions: Results will be used to improve the VR program, with the goal of producing a cost-effective, accessible and easy to individualize therapeutic approach. The pilot data will be used for designing a larger scale clinical trial.

A task-specific interactive game-based virtual reality rehabilitation system for patients with stroke: a usability test and two clinical experiments

BackgroundVirtual reality (VR) is not commonly used in clinical rehabilitation, and commercial VR gaming systems may have mixed effects in patients with stroke. Therefore, we developed RehabMaster™, a task-specific interactive game-based VR system for post-stroke rehabilitation of the upper extremities, and assessed its usability and clinical efficacy.MethodsA participatory design and usability tests were carried out for development of RehabMaster with representative user groups. Two clinical trials were then performed. The first was an observational study in which seven patients with chronic stroke received 30 minutes of RehabMaster intervention per day for two weeks. The second was a randomised controlled trial of 16 patients with acute or subacute stroke who received 10 sessions of conventional occupational therapy only (OT-only group) or conventional occupational therapy plus 20 minutes of RehabMaster intervention (RehabMaster + OT group). The Fugl-Meyer Assessment score (FMA), modified Barthel Index (MBI), adverse effects, and drop-out rate were recorded.ResultsThe requirements of a VR system for stroke rehabilitation were established and incorporated into RehabMaster. The reported advantages from the usability tests were improved attention, the immersive flow experience, and individualised intervention. The first clinical trial showed that the RehabMaster intervention improved the FMA (P = .03) and MBI (P = .04) across evaluation times. The second trial revealed that the addition of RehabMaster intervention tended to enhance the improvement in the FMA (P = .07) but did not affect the improvement in the MBI. One patient with chronic stroke left the trial, and no adverse effects were reported.ConclusionsThe RehabMaster is a feasible and safe VR system for enhancing upper extremity function in patients with stroke.

Task-specific interactive game-based virtual reality rehabilitation system for stroke patients: A usability test and two clinical experiments

Task-specific interactive game-based virtual reality rehabilitation system for stroke patients: A usability test and two clinical experiments