Head-mounted Display Research Articles

Wavelength-Tunable Textile-Based Organic Light-Emitting Diode for Multifunctional Wearable Photomedical Applications and Display with Cool White to Warm White Light

Wavelength-Tunable Textile-Based Organic Light-Emitting Diode for Multifunctional Wearable Photomedical Applications and Display with Cool White to Warm White Light

Individual and Situational Characteristics of the Occurrence of Cyber Sickness in the Context of Virtually Supported Military Training

Abstract Cyber sickness (CS) is considered a major challenge in the use of virtual reality (VR). This impacts the planned implementation of VR in the training of operational forces. The present work aimed to investigate the prevalence and onset of CS during virtually supported military training using head-mounted displays (HMDs) and explore related predictor variables. For this purpose, a quantitative cross-sectional study was conducted in which German soldiers (N = 100) were exposed to an immersive fifteen-minute VR scenario. We measured CS severity, age, heart rate (HR), and skin conductance (SC). Using newly developed categories to classify CS severity, the results showed a small prevalence (4%) of CS in the studied sample. Susceptibility to CS was the only predictor of the occurrence of CS symptoms. Accordingly, the present work provides evidence that CS may play a minor role in affecting virtually supported operational training. At the same time, the easily detectable susceptibility to CS promises rapid detection of vulnerable users. Implications and further research are discussed to detect, control, and mitigate CS.

Microvascular decompression in trigeminal neuralgia using a robot-assisted exoscope and head-mounted display.

Microvascular decompression (MVD) in trigeminal neuralgia (TN) is currently managed using an operating microscope (OM). Recent experiences with endoscopy-assisted, fully endoscopic, and exoscopic surgery have been described, aiming to improve ergonomics and image quality. The aim of this study was to report the first series of patients operated on with the aid of a robotic binocular exoscope using a head-mounted display (RoboticScope). From September 2023 to March 2024, 9 patients with TN were treated using the RoboticScope. A classic mini-retrosigmoid approach was performed and standard microsurgical techniques were applied. Surgical timing, ergonomics, visual performances, adverse events, and 1-month postoperative pain outcomes were evaluated. All surgeries were completed without shifting to the OM. Surgeon comfort with the RoboticScope was better compared with the OM and visualization was good. No intraoperative adverse events were recorded. The duration of the procedure was significantly shorter with the RoboticScope compared to those using the OM (median 18 vs 34 minutes, p = 0.0001). MVD can be safely and effectively performed using the RoboticScope. Surgeons benefit from better ergonomics, stereoscopic image quality, and shorter surgical duration.

Virtual Reality Therapy for Chronic Pain: A Scoping Review on Indications, Mechanisms of Action, and Effectiveness

Background: The application of virtual reality (VR) technology as a nonpharmacologic treatment option for chronic pain has been increasingly studied. However, the mechanisms underlying this treatment modality's potential positive effects and appropriate indications are not well understood or summarized in the literature. Objectives: This scoping review aims to better understand the chronic pain populations best indicated for head-mounted display-based VR interventions, explore their efficacy on pain score reduction, and characterize the mechanisms of action underlying their efficacy. Methods: PubMed database systematic searches were conducted including articles from January 2010 to August 2023 with primary qualifying criteria including but not limited to use of head-mounted display VR and adequate VR treatment dosage. Mechanisms of action(s) were deduced via an exploratory approach whereby characteristics of VR treatment interventions were analyzed and categorized. Results: Fourteen studies met qualifying criteria, representing a total treatment group of 327. Study data extracted were solely relative to VR treatment group participants. VR intervention mechanisms of action were best characterized via 2 broad but distinct categories: addressing kinesiophobia and psychobehavioral modulation. Three studies investigating chronic neck pain used addressing kinesiophobia as a mechanism of action and demonstrated a significant improvement [weighted average numerical rating scale (NRS): 4.6 at baseline, 2.5 post-intervention, and 2.5 3 months post-intervention]. Six studies investigated chronic low back pain, for which 5 studies, representing 99% of the subgroup, used psychobehavioral modulation. Each demonstrated significant reduction in pain (weighted average NRS: 5.1 baseline and 3.2 post-intervention). Conclusion: This large-scale within-group analysis review proposes 2 broad mechanisms of action underlying the efficacy of VR interventions for chronic pain indications. VR interventions addressing kinesiophobia seem to be significantly effective in nontraumatic chronic neck pain patients. Psychobehavioral VR interventions demonstrate significant efficacy in the chronic low back pain population. Studies with interventions targeting nonspecific chronic pain populations did not show significant results.

Creating An Immersive Business Simulation: The Virtual Reality (Vr) Coffee Shop

ABSTRACT Virtual reality (VR) learning is believed to increase focus, engagement, and emotional connection. To that end, we developed an immersive business case study in VR to teach essential business concepts. This paper outlines the process we followed to develop and launch the case in the hope that other institutions can use our process as a blueprint for launching their own similar VR case simulations. In an immersive virtual space using head-mounted display (HMD) headsets, students navigate various business challenges, make cross-disciplinary decisions, and witness real-time outcomes across four increasingly complex scenarios. This immersive learning approach allows students to safely practice making challenging decisions and learn from mistakes, gaining insights into the consequences of their choices in a uniquely compelling way and developing a comprehensive understanding of various business aspects, including finance, operations, marketing, management, and social responsibility. User testing included an in-headset test to assess usability, engagement, and educational value of the VR simulation in a controlled environment. The VR case simulation was found to be more engaging than more conventional learning approaches, helped to reduce distractions to a greater extent, and offered greater tangibility around decisions and consequences.

Immersive documentary journalism: exploring the impact of 360° virtual reality compared with a 2D screen display on the responses of people toward undocumented young migrants to Spain

The term ‘MENA’ refers to ‘Menores Extranjeros No Acompañados’ (‘unaccompanied foreign minors’) who are child immigrants to Spain who entered alone without legal documentation. Over the years, ‘mena’ has become a pejorative term associated with criminality, a view especially promoted by some on the political far right. In this article, we describe an experiment where virtual reality (VR) was used to place people among a group of young adults with a ‘MENA’ background (‘ex-mena’) to explore how their experience might alter their attitudes about the plight of the MENA. In particular, we were interested in the different influence of a 360 3D video or the same video on a 2D large screen, both experienced through the same VR head-mounted display. There were 51 people recruited for the experimental study, 28 of whom experienced the video in the screen condition and 23 in the 360 video condition. In addition to questionnaires, a sentiment analysis was carried out on short essays that participants wrote after their experience. The results show that sentiment was greater for the 360 video condition than the screen. Lower sentiment scores are associated with sadness, media bias, feeling bad about the conditions of the MENA, the difficulty of integration, and the utility of understanding and empathy. Higher sentiment scores are associated with empathy due to being closer to the situation, knowing the story of the migrants better, politicization, prejudging, feeling sorry for the manipulation of the migrants, and failure of action by the authorities. The 360 video approach used could be an important tool for documentary journalism.

Comparison of augmented reality with other teaching methods in learning anatomy: A systematic review.

Augmented reality (AR) has been investigated as an engaging educational tool that motivates undergraduate health science students to learn human anatomy. AR technology is developing rapidly, supporting medical education by presenting models of human anatomy as digital objects overlaid in the real world via mobile or head-mounted display (HMD). The purpose of this systematic review is to provide a post-pandemic analysis of AR compared with other methods for teaching anatomy and to determine the effects of AR on learning outcomes (LOs). Original research published between January 2020 and April 2024 was obtained from the WOS, Scopus, MEDLINE(Ovid), EMBASE, and PubMed databases, following PRISMA 2020 protocols. Articles included for analysis compared AR with alternative pedagogical methods of teaching undergraduate human anatomy. Studies that described AR as "mixed reality" (MR) were included, while those describing "virtual reality" (VR) were not considered. Risk of bias and limitations in individual studies were assessed using the Quality Assessment with Diverse Studies (QuADS) tool. Data were synthesized using a convergent integrated approach with LOs tabulated for visual analysis. A total of 17 articles were eligible for review: nine studies comparing AR via HMD hardware, and eight comparing mobile AR. The LOs of 12 studies were overwhelmingly reported as non-significant. Insufficient data precluded an accurate meta-analysis of LOs, and critical analysis revealed a considerable risk of bias and lack of justified methodology. While AR holds potential for supporting undergraduate students in learning anatomy, definitive outcomes from the current literature are limited by the heterogeneous nature of the studies and inconsistent use of terminology. It is recommended that future research employs professional AR technologies and incorporates the perspectives of university educators to ensure reliable outcomes that can direct the further development of AR technology in medical education.

Mechanically Driven, Continuous Synthesis of Chiroplasmonic Assemblies.

Chiral plasmonic nanomaterials─with their significant applications in protein detection, drug screening, and enantioselective sensing─necessitate an industrialized fabrication procedure to enhance their commercial viability. However, the prevailing manufacturing of chiral plasmonic nanoparticles and assemblies heavily leans on manual intervention, causing time-consuming and quality-inconsistent concerns. Here, we develop an automated, continuous mechanical synthesis system that consistently sprays metal nanowires to create chiroplasmonic assemblies: a macroscopic twisted layered structure comprising equivalent linear birefringence layers, approximate linear polarizer layers, and a precise angular offset between them. Utilizing the synthesis-with-automation system, we scale up the production of chiral plasmonic films, generating high optical asymmetry (g-factor, with the order of 10-1) across a broadband ranging from ultraviolet to near-infrared wavelengths. We further introduce the portable chiral sensing, expanding plasmonic assemblies into flexible materials and integrating them with wearable real-time display devices. Our mechanically driven, continuous synthesis of chiral plasmonic structures presents an intriguing pathway to facilitate functional chiral structures toward practice.

The effect of distance on audiovisual temporal integration in an outdoor virtual environment

In this study, we explore the influence of stimulus distance on human tolerance for (physical) asynchronies in virtual reality (VR). A repeated audiovisual (AV) stimulus with sound and light bursts was presented to the participants in an outdoor virtual environment (VE) using a head-mounted display (HMD). The investigation focused on quantifying the point of subjective simultaneity (PSS) for both visual and auditory stimuli. A synchrony judgment method (SJ-3) was used for 11 stimulus onset asynchronies (SOA) and five egocentric distances from 10 m up to 50 m with 10 m increments. The data analysis showed negative PSS values that decreased with distance, resulting in a negative slope (-3 ms/m) of the regression line between PSS values and simulated distances. In contrast to the recent study conducted in the indoor VE, we conclude that the presented study in the outdoor VE does not incorporate a distance compensation mechanism and refutes the hypothesis of an ‘implicit estimation’ of sound-arrival time. The reasons behind the observed contrast are discussed in this paper. Moreover, the negative slope of the regression line (−3 ms/m) is similar to previous research, concluding that there is a temporal integration of auditory-visual information within human neural processes without distance compensation.

Design and verification of universal virtual shopping store application

The aim of this study was to design the user experience for a head-mounted display (HMD)-based universal virtual shopping store by conducting a literature analysis and employing video ethnography techniques. Subsequently, a prototype was developed to validate the outcomes. Despite the growing trend of contactless shopping, with various brands launching virtual store platforms, these often lack the elements and experiences that users find satisfying. To address this gap, we analysed users’ offline shopping experiences using video ethnography. The insights gained informed the development of a prototype that adopts a universal design approach, incorporating key features and interface designs tailored for a virtual store environment. The prototype includes innovative features include tutorials, avatar-based virtual fitting, user location/orientation control, and voice guidance. It also incorporates design features such as colour customisation, high contrast, central interface placement, and visual cues for differentiating product types. To validate the prototype’s usability, a study was conducted with 30 university students in their 20s (mean age 23.3 years, SD = 1.8), revealing high levels of satisfaction with its functionality and interface design. Further, in-depth interviews revealed that the appropriate design of features and interfaces, aligned with shopping goals and intentions, significantly enhanced interest in and engagement with virtual shopping. The prototype’s key features, representative of the main outcomes of this study, provide valuable insights for the future development of related services.

Augmented Reality Versus Freehand Spinopelvic Fixation in Spinal Deformity: A Case-Control Study.

This study sought to compare screw placement accuracy and outcomes between freehand (FH) and AR-guided pelvic fixation. While pelvic fixation is a critical technique in spinal deformity surgery, S2-alar iliac (S2AI) screw placement poses challenges. We conducted a case-control study of 50 consecutive patients who underwent spinopelvic fixation at a single institution. AR guidance was performed using a head-mounted display (Xvision, Augmedics). Patient demographics, surgical characteristics, spinopelvic parameters, and screw breach grade were compared using univariate and multivariate statistics. Pelvic fixation was performed FH in 21 patients (median age, 64; female, 38.1%; median BMI 32.3kg/m2) and AR-guided in 29 patients (median age, 66; female, 51.7%; median BMI 28.4kg/m2). Mean follow-up was longer in the FH group (28 mos vs 11 mos, P < 0.001). Pelvic fixation in the FH group was performed using either S2AI (90.5%) or dual S2AI (9.5%) screws. There were no significant differences in length of surgery (FH, 439 minutes; AR, 490 minutes; P = 0.1) or estimated blood loss (FH, 2.1L; AR, 1.9L; P = 0.7). Accuracy of FH pelvic fixation was 95.6% (43/45 screws) and accuracy of AR pelvic fixation was 96.5% (55/57 screws). Multivariable logistic regression for screw breach revealed no significant association with AR guidance when controlling for age, BMI, osteoporosis, and smoking. We present the first case-control study of AR-guided spinopelvic fixation, with findings suggesting parity between FH and AR-guidance, serving as foundation for prospective controlled studies with longitudinal follow-up to interrogate the benefits of AR-guidance in spinal deformity surgery.

An Empirical Study on Social Anxiety in a Virtual Environment through Mediating Variables and Multiple Sensor Data

Social anxiety disorder is a psychological condition characterized by excessive nervousness in social situations, such as interpersonal interactions. Exposure therapy has shown benefits in its treatment, and virtual reality (VR) technology has gained much attention for reducing physical and psychological distance and providing additional quantitative evidence from the data generated by standard VR devices (e.g., head-mounted display). Clinical psychology studies have highlighted the importance of mediating variables of social anxiety; however, existing VR-based social anxiety studies have neglected such variables with respect to user experience and data analysis in the context of VR, although these variables could provide insights into the design and use of VR for the treatment of social anxiety. In this study, we focused on two representative mediating variables of social anxiety: (1) the gap between self-presentation motivation and expectancy , and (2) self-focused attention . We used sensor data (e.g., head movement, eye movement, eye gaze, and psychological signals) to investigate the impact of these variables on users' anxiety responses in VR. We developed &lt;u&gt;VR&lt;/u&gt;-based &lt;u&gt;S&lt;/u&gt;ocial Anxiety Support &lt;u&gt;T&lt;/u&gt;ool (VRST) that reflects the theoretical design elements of effective anxiety provocation. Based on the results of a user study with 30 participants, we confirmed that the mediating variables were associated with social anxiety in the VR environment. We also found that the mediating variables were associated with eye gaze, eye pupil, head movement, and body temperature. Our study results provide researchers, designers, and practitioners with empirical evidence and implications for the use of VR technology and sensor data in the mental health context.

Estimation of horizontal spatial specifications for ideal head-mounted displays in practical conditions

This study presents the horizontal spatial specifications required for developing ideal head-mounted displays (HMDs) that provide visual experiences indistinguishable from those obtained without wearing HMDs. We investigated the minimum specifications for pixel density and field of view (FoV) such that users cannot perceive any degradation in these aspects. Conventional studies have measured visual acuity in the periphery and FoV size without eye movement. However, these results are not sufficient to determine the spatial specifications because users may notice a degradation in the quality of images displayed in the periphery when shifting their gaze away from the front. In this study, we measured visual characteristics under practical conditions, wherein participants moved their eyes naturally in coordination with their head movements, as observed when viewing natural scenes. Using a cylindrical display that covered the participant’s entire horizontal visual field with high resolution images, we asked participants to identify degraded spatial resolution or narrowed FoV. Results showed that ideal HMDs do not have to provide spatial frequency components above 0.5 and 2 cycles per degree outside the visual fields of approximately 210° and 120° horizontally, respectively. These results suggest that a resolution equivalent to one-fifteenth of the frontal area is sufficient for the lateral areas of the head. In addition, we found that ideal HMDs require a FoV of at least 240°. This is considerably smaller than a naive estimate of 310° based on previous studies, obtained by integrating the FoV size during fixation and the movable range of the eyes. We believe that these findings will be helpful in developing ideal HMDs.

Assessing the Use of Virtual Pointers in Laparoscopic Surgery Training Activities.

Laparoscopic surgery has advanced significantly; however, effective communication within the surgical team remains challenging, particularly in training scenarios where misinterpretation of instructions can lead to errors. Virtual pointers, indicating the instructor's gaze through eye-tracking devices and overlaying it onto the screen using augmented reality (AR), can enhance understanding and reduce errors. In a study involving 10 participants divided into experts and novices in laparoscopic surgery, various pointers (differing in shape, size and colour) were analysed in an AR environment using the HoloLens2 device. The aim was to assess the acceptance of these pointers by both groups, understand how their characteristics affect perception, and evaluate the AR device's usefulness. Initial results showed an 80% acceptance rate. After analysing the pointers, this decreased to 60%, as some experts changed their opinion from positive to neutral. The study revealed that the characteristics of the pointers significantly affect their perception, with large, thick-rimmed pointers being preferred. Orange was the best-performing colour. The device used also influenced perception, as experts who changed their perception criticised certain aspects of the head-mounted display. The study highlights the potential of virtual pointers to improve communication in laparoscopic training, particularly when their size, shape, and colour are optimised. Further research with a larger sample size is needed to confirm these results and explore the HoloLens2's influence on users' perceptions. These insights could guide the development of more effective training tools for minimally invasive surgery.

Training transfer validity of virtual reality simulator assessment

This study utilises computer-based simulations to explore the transfer effects of competency training in maritime education, addressing the current lack of research on their transferability to real-world scenarios.The research explores the accuracy of procedural knowledge assessment using virtual reality (VR), positing that head-mounted display (HMD) VR offers stronger concurrent validity through training transfer measures than 3D desktop VR. This is evaluated by regression on a training transfer condition. It also investigates motivation’s influence on training transfer and the regression model of this relationship.Fifteen marine engineering students were divided into two experimental groups using 3D desktop VR and HMD VR systems, with eight experts in the control group. The students had previously received traditional lecture-based instruction and were given practical training using a 2D desktop simulator in the same scenario as in the VR treatment and in the training transfer condition.The ANCOVA design experiment involved two levels of technical immersion before the operation of real-life equipment. Neither technical immersion nor expertise level as independent variables were found to have a significant effect in the relationship of the assessment predicting the training transfer. The direct relationship was significant (R2adj = 0.436) and further analysed with the influence of motivation, resulting in a moderation model with a decent effect size (R2 = 0.740). Based on these findings, we can infer that both types of VR simulations used for assessment demonstrate concurrent validity in predicting real-life performance before we discuss and define the characteristics of the observed transfer according to theory.

Minimally Invasive Approaches to Spinal Cerebrospinal Fluid Leak Repair: Current Strategies and a Novel Technique.

Spinal cerebrospinal fluid (CSF) leaks can be caused by tears in the dura and are challenging to treat. Traditional methods of treating spinal CSF leakage include nonsurgical management, epidural blood patches (EBP), and direct surgical repair. Minimally invasive surgery (MIS) is rapidly progressing within neurosurgery due to its advantages for patient safety and comfort. Existing MIS techniques to spine surgery utilize a rigid endoscope, which has limitations when reaching smaller areas requiring greater degrees of visualization. The simultaneous use of a flexible endoscope and wearable heads-up display (wHUD) improves access and visualization in these small areas while allowing the surgeon to maintain optimal ergonomics. In this article, we review minimally invasive approaches to spine surgery and the management of spinal CSF leaks. We also demonstrate a novel minimally invasive technique utilizing flexible endoscopy and a wHUD to treat a case of recurrent CSF leak. We describe the successful utilization of this technology and provide the groundwork for future practitioners to incorporate this approach into their practice.

Decoupled Edge Physics Algorithms for Collaborative XR Simulations

ABSTRACTThis work proposes a novel approach to transform any modern game engine pipeline, for optimized performance and enhanced user experiences in extended reality (XR) environments decoupling the physics engine from the game engine pipeline and using a client‐server architecture creates a scalable solution, efficiently serving multiple graphics clients on head‐mounted displays (HMDs) with a single physics engine on edge‐cloud infrastructure. This approach ensures better synchronization in multiplayer scenarios without introducing overhead in single‐player experiences, maintaining session continuity despite changes in user participation. Relocating the Physics Engine to an edge or cloud node reduces strain on local hardware, dedicating more resources to high‐quality rendering and unlocking the full potential of untethered HMDs. We present four algorithms that decouple the physics engine, increasing frame rates and Quality of Experience (QoE) in VR simulations, supporting advanced interactions, numerous physics objects, and multiuser sessions with over 100 concurrent users. Incorporating a Geometric Algebra interpolator reduces inter‐calls between dissected parts, maintaining QoE and easing network stress. Experimental validation, with more than 100 concurrent users, 10,000 physics objects, and softbody simulations, confirms the technical viability of the proposed architecture, showcasing transformative capabilities for more immersive and collaborative XR applications without compromising performance.

Evaluation of monocular and binocular contrast perception on virtual reality head-mounted displays.

Visualization of medical images on a virtual reality (VR) head-mounted display (HMD) requires binocular fusion of a stereoscopic pair of graphical views. However, current image quality assessment on VR HMDs for medical applications has been primarily limited to time-consuming monocular optical bench measurement on a single eyepiece. As an alternative to optical bench measurement to quantify the image quality on VR HMDs, we developed a WebXR test platform to perform contrast perceptual experiments that can be used for binocular image quality assessment. We obtained monocular and binocular contrast sensitivity responses (CSRs) from participants on a Meta Quest 2 VR HMD using varied interpupillary distance (IPD) configurations. The perceptual result shows that contrast perception on VR HMDs is primarily affected by optical aberration of the VR HMD. As a result, monocular CSR degrades at a high spatial frequency greater than 4 cycles per degree when gazing at the periphery of the display field of view, especially for mismatched IPD settings consistent with optical bench measurements. On the contrary, binocular contrast perception is dominated by the monocular view with superior image quality measured by the contrast. We developed a test platform to investigate monocular and binocular contrast perception by performing perceptual experiments. The test method can be used to evaluate monocular and/or binocular image quality on VR HMDs for potential medical applications without extensive optical bench measurements.

Gaze-Contingent Layered Optical See-Through Displays with a Confidence-Driven View Volume.

The vergence-accommodation conflict (VAC) presents a major perceptual challenge for head-mounted displays with a fixed image plane. Varifocal and layered display designs can mitigate the VAC. However, the image quality of varifocal displays is affected by imprecise eye tracking, whereas layered displays suffer from reduced image contrast as the distance between layers increases. Combined designs support a larger workspace and tolerate some eye-tracking error. However, any layered design with a fixed layer spacing restricts the amount of error compensation and limits the in-focus contrast. We extend previous hybrid designs by introducing confidence-driven volume control, which adjusts the size of the view volume at runtime. We use the eye tracker's confidence to control the spacing of display layers and optimize the trade-off between the display's view volume and the amount of eye tracking error the display can compensate. In the case of high-quality focus point estimation, our approach provides high in-focus contrast, whereas low-quality eye tracking increases the view volume to tolerate the error. We describe our design, present its implementation as an optical-see head-mounted display using a multiplicative layer combination, and present an evaluation comparing our design with previous approaches.

Immersive virtual reality for learning exoskeleton-like virtual walking: a feasibility study

PurposeVirtual Reality (VR) has proven to be an effective tool for motor (re)learning. Furthermore, with the current commercialization of low-cost head-mounted displays (HMDs), immersive virtual reality (IVR) has become a viable rehabilitation tool. Nonetheless, it is still an open question how immersive virtual environments should be designed to enhance motor learning, especially to support the learning of complex motor tasks. An example of such a complex task is triggering steps while wearing lower-limb exoskeletons as it requires the learning of several sub-tasks, e.g., shifting the weight from one leg to the other, keeping the trunk upright, and initiating steps. This study aims to find the necessary elements in VR to promote motor learning of complex virtual gait tasks.MethodsIn this study, we developed an HMD-IVR-based system for training to control wearable lower-limb exoskeletons for people with sensorimotor disorders. The system simulates a virtual walking task of an avatar resembling the sub-tasks needed to trigger steps with an exoskeleton. We ran an experiment with forty healthy participants to investigate the effects of first- (1PP) vs. third-person perspective (3PP) and the provision (or not) of concurrent visual feedback of participants’ movements on the walking performance – namely number of steps, trunk inclination, and stride length –, as well as the effects on embodiment, usability, cybersickness, and perceived workload.ResultsWe found that all participants learned to execute the virtual walking task. However, no clear interaction of perspective and visual feedback improved the learning of all sub-tasks concurrently. Instead, the key seems to lie in selecting the appropriate perspective and visual feedback for each sub-task. Notably, participants embodied the avatar across all training modalities with low cybersickness levels. Still, participants’ cognitive load remained high, leading to marginally acceptable usability scores.ConclusionsOur findings suggest that to maximize learning, users should train sub-tasks sequentially using the most suitable combination of person’s perspective and visual feedback for each sub-task. This research offers valuable insights for future developments in IVR to support individuals with sensorimotor disorders in improving the learning of walking with wearable exoskeletons