Immersive Virtual Reality Game Research Articles

Virtual reality gameplay classification illustrates the multidimensionality of visuospatial neglect

Abstract Brain injuries can significantly impact mental processes, and lead to hidden disabilities not easily detectable. Traditional methods for assessing these impacts are imprecise, leading to unreliable prevalence estimates and treatments with uncertain effectiveness. Immersive virtual reality has shown promise for assessment, but its use as a standalone tool is rare. Our research focused on developing and validating a standalone immersive virtual reality classification system for unilateral spatial neglect, a condition common following brain injury characterised by inattention to one side of space. Our study involved 51 brain injury inpatients and 30 controls, all engaging with “The Attention Atlas,” an immersive virtual reality game for testing visual search skills. Our classification system aimed to identify patients with neglect, “minor atypicality” (indicative of inattention not consistent enough to be labelled as neglect), or non-neglect. This categorisation was based on a simple mathematical definition, utilising gameplay to describe spatial orientation (to the left or right side) and attentional challenge (indicative of search inefficiency). These metrics were benchmarked against a normative model to detect atypical visual search, which refers to gameplay beyond the usual bounds. The combination of neglected side, orientation, and challenge factors were used to categorise neglect. We discovered a strong correlation between atypical visual search patterns and neglect risk factors, such as middle cerebral artery stroke, parietal injuries, and existing neglect diagnoses (Poisson regression incidence rate ratio = 7.18, 95% CI = 4.41-11.90). In our study, immersive virtual reality identified neglect in one-fourth of the patients (n = 13, 25.5%), minor atypicality in 17.6% (n = 9), and non-neglect in the majority, 56.9% (n = 29). This contrasts with standard assessments, which detected neglect in 17.6% (n = 9) of cases and had no intermediate category. Our analysis determined six categories of neglect, the most common being left hemispace neglect with above-median orientation and challenge scores. Traditional assessments were not significantly more accurate (accuracy = 84.3%, P = .06) than a blanket assumption of non-neglect. Traditional assessments were also relatively insensitive in detecting immersive virtual reality-identified neglect (53.8%), particularly in less severe cases and those involving right side inattention. Our findings underline the effectiveness of immersive virtual reality in revealing various dimensions of neglect, surpassing traditional methods in sensitivity and detail, and operating independently from them. To integrate immersive virtual reality into real-world clinical settings, collaboration with healthcare professionals, patients, and other stakeholders is crucial to ensure practical applicability and accessibility.

Evaluations of Virtual and Augmented Reality Technology-Enhanced Learning for Higher Education

Virtual reality (VR) has good potential to promote technology-enhanced learning. Students can benefit from immersive visualization and intuitive interaction in their learning of abstract concepts, complex structures, and dynamic processes. This paper is interested in evaluating the effects of VR learning games in a Virtual and Augmented Reality Technology-Enhanced Learning (VARTeL) environment within an engineering education setting. A VARTeL flipped classroom is established in the HIVE learning hub at Nanyang Technological University (NTU) Singapore for the immersive and interactive learning. Experiments are designed for the university students conducting the learning, with three interactive and immersive VR games related to science, technology, engineering and mathematics (STEM), i.e., virtual cells, a virtual F1 racing car, and vector geometry. These VR games are a part of the VARTeL apps designed in-house at NTU for STEM education. Quantitative and qualitative analyses are performed. A total of 156 students from Mechanical Engineering participated in the experiment. There are 15 participants selected for an interview after the experiment. Pre-tests and post-tests are performed using two different models, the developed VARTeL and the modified Technology-Rich Outcome-Focused Learning Environment Inventory (TROFLEI), in order to measure the efficiency of the VARTeL environment in Higher Education. Significant improvements of about 24.8% are observed for the post-tests over the pre-tests, which illustrate the effectiveness of the VARTeL for Engineering education. Details of the VR simulation games, methods of data collection, data analyses, as well as the experiment results are discussed. It is observed from the results that all the underlying scales of the modified TROFLEI are above the threshold for the ‘Good’ category, indicating that a very reliable questionnaire is designed in this research. The mean ‘Ideal’ values are about 0.7–2.6% higher than the mean ‘Actual’ values. The limitations of the experiment and future works with recommendations are also presented in this paper.

Creating an Immersive Virtual Reality Game Space for Multiuser, Synchronous Co-Located Collaboration: Design Considerations and Influencing Factors

The last decade has witnessed the rapid development of immersive virtual reality (IVR) and its application in various contexts. However, its application in supporting real-time virtual collaboration has been quite rare due to technical barriers and the lack of validated design principles. To address this research gap, this study designed and developed an IVR space to enable multiuser synchronous co-located collaboration to complete a fantasy game. An evaluation study (N = 95) was conducted to explore its useful design considerations and the influencing factors for collaboration experience in the game. The IVR space was enabled by the simultaneous localization and mapping (SLAM)-based inside-out tracking technique and was informed by four essential design considerations for promoting effective collaboration in IVR, namely, the role script, learning task, collaboration mechanism, and communication design. The study results revealed that students in general were satisfied with their collaboration experience in IVR, with social presence and collaboration competency as significant predictors of collective efficacy and social experience. Based on both quantitative and qualitative results, this study proposes four validated principles for designing effective IVR spaces to support synchronous co-located collaboration.

Impact of immersive virtual reality games or traditional physical exercise on cardiovascular and autonomic responses, enjoyment and sleep quality: a randomized crossover study

Objectives: To assess the potential of immersive virtual reality (IVR) in achieving moderate exercise intensity, and 2) to examine the acute effects of two IVR exergame sessions (BOXVR and Beat Saber), comparing them with the impact of traditional exercise on heart rate variability (HRV), perceived effort, delayed onset muscle soreness, motivation, and sleep. Materials and methods: A crossover design was used. The participants (n = 22) randomly performed two sessions of IVR and one session of moderate intensity physical activity, each session lasting 30 min. Heart Rate (HR) and HRV, Perceived Exertion Scale, Intrinsic Motivation Inventory, sleep quality, and perceived pain, were evaluated. Results: The cardiac response to the activities was significantly higher when participants performed traditional physical activity as compared to the BOXVR and Beat Saber games. Traditional training provided a different HRV response as compared to Beat Saber (LnRMSSD, p = 0.025; SDNN, p = 0.031). Although the sessions were planned for moderate intensity, BOXVR generated a moderate intensity (49.3% HRreserve), Beat Saber (29.6% HRreserve) a light one, and the Circuit session, a vigorous one (62.9% HRreserve). In addition, traditional training reported higher perceived exertion and pain with less enjoyment. Differences were observed between the exergames. BOXVR resulted in a lower cardiac response (HRmax and HRmean), and a higher perception of exertion and pain at 72 h. The sleep variables analyzed were not altered by any of the sessions. Conclusions: BOXVR and traditional training can lead to moderate intensity physical activity. However, traditional training could result in lower adherence to physical exercise programs, as it was perceived as more intense and less enjoyable.

Potential factors contributing to observed sex differences in virtual-reality-induced sickness

Virtual reality (VR) technology has been widely adopted for several professional and recreational applications. Despite rapid innovation in hardware and software, one of the long prevailing issues for end users of VR is the experience of VR sickness. Females experience stronger VR sickness compared to males, and previous research has linked susceptibility to VR sickness to the menstrual cycle (Munafo et al., Exp Brain Res 235(3):889–901). Here we investigated the female versus male experience in VR sickness while playing an immersive VR game, comparing days of the menstrual cycle when hormones peak: day 15 (ovulation—peak estrogen) and day 22 (mid-luteal phase—peak progesterone). We found that immersion duration was greater in the second session than the first, and discomfort was lessened, suggesting a powerful adaptation with repeated exposure. Due to the estrogen levels changing along with the exposure, there was no clear independent impact of that; note, though, that there was a significant difference between self-report and physiological measures implying that GSR is potentially an unreliable measure of motion sickness. Although prior work found a delay over 2 days between session would not allow adaptation and habituation to reduce VR sickness susceptibility, we found that a week delay has potential success.

Correction: Investigating Engagement and Flow with a Placed-Based Immersive Virtual Reality Game

Correction: Investigating Engagement and Flow with a Placed-Based Immersive Virtual Reality Game

IVAL: Immersive Virtual Anatomy Laboratory for enhancing medical education based on virtual reality and serious games, design, implementation, and evaluation

Learning anatomy is a complex subject that requires a thorough understanding of 3D structures, posing challenges with traditional teaching methods. Anatomy education often involves the use of cadavers, which can be expensive, time-consuming, and ethically complex. As a result, medical educators need effective ways to engage students and promote learning. Immersive virtual reality (IVR) and serious games (SGs) provide innovative and immersive learning experiences that enhance students’ understanding and retention of anatomical concepts and improve the effectiveness of anatomy education. This work aims to develop and evaluate the effectiveness of IVAL,11Immersive Virtual Anatomy Laboratory. an Immersive Virtual Anatomy Laboratory, for immersive and engaging learning experiences. A study involving dozens of University students assessed the efficacy of this innovative tool, resulting in high levels of satisfaction, success, and learning outcomes. IVAL was found to be an effective tool in promoting learning and retention of anatomical concepts, with participants highly rating the tool regarding engagement and learning enhancement. This study demonstrates that immersion in a 3D representation of the skeletal system through VR is essential for a deep knowledge of anatomical learning. These results have important implications for medical educators because IVR technologies can enhance student learning and improve the effectiveness of medical education.

Educational Seismology through an Immersive Virtual Reality Game: Design, Development and Pilot Evaluation of User Experience

Virtual Reality (VR), especially in its immersive form, is a promising technology employed to support education and training in various fields. VR offers unique opportunities to experience situations and environments that are otherwise inaccessible or risky. Educational Seismology aims to inform and educate the public on earthquakes; to this end, the use of VR is investigated as an attractive solution. VRQuake is an immersive VR application designed and developed for Educational Seismology purposes. VRQuake is structured in five consecutive scenes and is organized as a game. It allows users to interact with virtual objects in real time and apply learned rules and good practices in reaction to an earthquake, thus providing a dynamic learning environment. A pilot evaluation of VRQuake is performed by volunteer university students who play the game and then answer a questionnaire with closed- and open-type questions referring mostly to the user experience. Analysis of the answers has shown positive results regarding usability, clarity and acceptance of the application. Answers are also encouraging as to the educational potential of VRQuake. Furthermore, qualitative analysis of open-type questions has contributed user suggestions and demands that point to interesting new directions for further improvement of user experience and learning outcomes.

Using Ankle Weights as an Effective Way to Increase the Intensity of Physical Activity While Playing Immersive Virtual Reality Games on an Omnidirectional Treadmill

Active virtual reality games (AVRGs) have become more and more popular. As the intensity of this form of physical activity (PA) may be insufficient to achieve health-related benefits, it is worth looking for solutions that increase the intensity of PA. The main aim of the study was to evaluate the effect of leg loading in the form of ankle weights (AWs) on the PA intensity of young adults playing AVRGs using an omnidirectional treadmill. The enjoyment of the game and users’ perceptions of the usefulness of this type of exercise were also evaluated. The study involved 26 university students. Each participant played an AVRG game on an omnidirectional treadmill twice, without and with ankle weights (2 kg per leg). The intensity of PA was evaluated using a heart rate monitor. The attractiveness of the game was assessed using the Physical Activity Enjoyment Scale (PACES). The study found that the percentage of maximum heart rate in participants playing AVRGs without ankle weights was significantly lower than that observed when playing with the weights. In both cases, PA intensity was high. A survey showed that the weights attached to the ankles did not affect the perceptions of the enjoyment of the game. The use of ankle weights appears to be an effective and simple way to increase the intensity of physical exercise during AVRGs based on locomotor movements performed with the lower limbs, especially since, according to study participants, such a procedure does not negatively affect the enjoyment of the game. Due to the high intensity of PA while playing VR games using an omnidirectional treadmill, it can be assumed that regular use of this solution is likely to provide health benefits.

Development of a Virtual Reality Escape Room Game for Emotion Elicitation

In recent years, the role of emotions in digital games has gained prominence. Studies confirm emotions’ substantial impact on gaming, influencing interactions, effectiveness, efficiency, and satisfaction. Combining gaming dynamics, Virtual Reality (VR) and the immersive Escape Room genre offers a potent avenue through which to evoke emotions and create a captivating player experience. The primary objective of this study is to explore VR game design specifically for the elicitation of emotions, in combination with the Escape Room genre. We also seek to understand how players perceive and respond to emotional stimuli within the game. Our study involved two distinct groups of participants: Nursing and Games. We employed a questionnaire to collect data on emotions experienced by participants, the game elements triggering these emotions, and their overall user experience. This study demonstrates the potential of VR technology and the Escape Room genre as a powerful means of eliciting emotions in players. “Escape VR: The Guilt” serves as a successful example of how immersive VR gaming can evoke emotions and captivate players.

Gamification of Cervical Spine Physiotherapy by Virtual Reality Software: Is This Real Rehabilitation?

Objective: Physical rehabilitation by virtual reality (VR) gamification is gaining acceptance. This study was designed to verify whether neck movements invoked by a fully immersive VR game environment may be physiotherapist-prescribed rehabilitation exercise. Methods: This was a single-visit prospective clinical trial (NCT03104647). Healthy participants put on VR headsets and entered a fully immersive game environment (VRPhysio, XRHealth, Tel Aviv, Israel) that prompted neck movement (flexion, extension, rotation, lateral bend, and combinations repeated twice in random order) accompanied by feedback encouraging correct performance. Four board-certified physiotherapists independently viewed videotapes recorded during the session, identified movements, and determined whether they were recommended as neck rehabilitation exercises. Results: Twenty (n = 20) participants (male-female ratio = 13:7; age = 38 ± 14 years old) completed the training session (16 movements per participant). All movements were identified correctly and determined to be appropriate for neck rehabilitation. No adverse events were reported. Conclusions: The VRPhysio software invoked movements identified by board-certified physiotherapists as appropriate for neck rehabilitation. The potential advantage of home-based VR gamification of cervical spine rehabilitation programs over common practice in motivating patient adherence warrants evaluation by randomized controlled trials.

Immersive virtual reality game for cognitive-empathy education: Implementation and formative evaluation

Immersive virtual reality game for cognitive-empathy education: Implementation and formative evaluation

Virtual reality increases pressure pain threshold and lowers anxiety in children compared with control and non-immersive control-A randomized, crossover trial.

Virtual reality (VR) is a promising non-pharmacological pain intervention because it may not only distract but also modulate pain by immersing the user in a three-dimensional 360° alternate reality. In children, VR has been reported to reduce clinical pain and anxiety during medical procedures. However, the effect of immersive VR on pain and anxiety remains to be investigated in randomized controlled trials (RCT). The aim of the present crossover RCT was to assess the effect of VR on pressure pain threshold (PPT) and anxiety level measured with the modified Yale Preoperative Anxiety Scale (mYPAS) in children in a controlled experimental setting. Seventy-two children (mean age 10.2 (6-14) years) were randomized to 24 sequences of four interventions (immersive VR Game, immersive VR video, tablet: 2D video and control: small talk). Outcome measures PPT, mYPAS and heart rate were assessed before and after each intervention. PPT increased significantly during VR game (PPTdiff): 136 kPa (CI 112; 161), p < 0.0001 and VR Video (PPTdiff): 122 kPa (CI 91; 153), p < 0.0001. Also, anxiety levels significantly decreased during both VR game (mYPASdiff: -7 points (-8 to -5), p < 0.0001) and VR video (mYPASdiff: -6 points (CI -7; -4), p < 0.0001). VR had a marked beneficial effect on PPT and anxiety compared with the control interventions: 2D video and small talk. Thus, immersive VR had a distinct modulatory effect on pain and anxiety in a well-controlled experimental setting. Immersive VR was effective and feasible in children and can act as a valid tool for non-pharmacological pain and anxiety management. Paediatric immersive VR seems to be beneficial although well-controlled studies are pending. We investigated whether immersive VR can modulate children's threshold for pain and anxiety level in an experimental well-controlled setting. We document a modulatory pain threshold increase and anxiety level decrease compared with extensive control conditions. Paediatric immersive VR is effective, feasible and valid for non-pharmacological pain and anxiety management. All efforts to reach the goal that no child should experience pain or anxiety when exposed to medical procedures.

A Commercial off-the-Shelf Immersive virtual reality game: its Effect on Engineering Students

A Commercial off-the-Shelf Immersive virtual reality game: its Effect on Engineering Students

Safety and Potential Usability of Immersive Virtual Reality for Brain Rehabilitation: A Pilot Study.

Objective: This study was conducted to demonstrate the safety and usability of an immersive virtual reality (VR) game as a rehabilitative training by assessing adverse events (AEs), adherence, and satisfaction in patients with brain injury who had free optional opportunities. Materials and Methods: The results were analyzed retrospectively. Seventy-eight patients with brain injury, undergoing rehabilitation treatment for motor impairment, were recruited. Among them, 51 were available for postintervention survey. The immersive type of VR training was programmed to facilitate use of the paralyzed upper extremity through a fishing simulation game. The Oculus Rift was used as head-mounted display device. Patients were observed for any AEs as defined in the Common Terminology Criteria for AEs during and after each VR training session. A postintervention telephone survey was done to investigate adherence-related factors and safety. Results: The results were analyzed after dividing the patients into nonadherence (patients participated <3 times) and high-adherence (≥3 times) groups. No serious AEs were reported during and after the VR training, and several patients reported other AEs, predominantly dizziness, with one case requiring cessation of VR training. Overall, the satisfaction rate was 54%. Compared with the nonadherence group, the high-adherence group expressed higher satisfaction with VR training, regarded it as effective for recovery from upper limb paralysis, accepted VR as comprehensible, and considered the level of difficulty to be appropriate (P < 0.05). Conclusion: Immersive VR training appeared to be safe for patients with brain injury.

The effect of narrative element incorporation on physical activity and game experience in active and sedentary virtual reality games.

The online version contains supplementary material available at 10.1007/s10055-023-00754-7.

Evaluating the Alterations Induced by Virtual Reality in Cerebral Small-World Networks Using Graph Theory Analysis with Electroencephalography.

Virtual reality (VR), a rapidly evolving technology that simulates three-dimensional virtual environments for users, has been proven to activate brain functions. However, the continuous alteration pattern of the functional small-world network in response to comprehensive three-dimensional stimulation rather than realistic two-dimensional media stimuli requires further exploration. Here, we aimed to validate the effect of VR on the pathways and network parameters of a small-world organization and interpret its mechanism of action. Fourteen healthy volunteers were selected to complete missions in an immersive VR game. The changes in the functional network in six different frequency categories were analyzed using graph theory with electroencephalography data measured during the pre-, VR, and post-VR stages. The mutual information matrix revealed that interactions between the frontal and posterior areas and those within the frontal and occipital lobes were strengthened. Subsequently, the betweenness centrality (BC) analysis indicated more robust and extensive pathways among hubs. Furthermore, a specific lateralized channel (O1 or O2) increment in the BC was observed. Moreover, the network parameters improved simultaneously in local segregation, global segregation, and global integration. The overall topological improvements of small-world organizations were in high-frequency bands and exhibited some degree of sustainability.

SnacktivityTM, Giant Games and Immersive Virtual Reality Exercises: A Rapid Narrative Review of These New Physical Activity Practices among Older People Living in Nursing Homes and Long-Term Care Facilities.

In developed countries, the increasing number of older adults raises many public health challenges. Physical activity can enable healthy aging, as it is beneficial for both mental and physical health. Despite this, not all older adults engage in physical activity or have access to it. To counteract this, new physical practices such as SnacktivityTM, giant games and immersive virtual reality exercises are being developed. The main objective of this rapid narrative review is to summarize the effects of SnacktivityTM, giant games and immersive Virtual Reality (VR) exercise among older adults living in nursing homes and long-term care facilities. A scientific review was performed using the search engines PubMed, PsycInfo and Web of Science on 7 July 2022. Fifty-nine items are identified in total, and five items are included in the literature review. Synthesis of the studies shows that immersive virtual reality and giant games improve the motivation and enjoyment of older adults and are beneficial for their functional abilities. Furthermore, no interventional studies have tested the effect of SnacktivityTM in older adults. This review suggests that future studies should be conducted to further explore the effects of these new physical activity practices in older adults living in nursing homes or long-term care facilities.

Path analysis of the roles of age, self-efficacy, and TAM constructs in the acceptance of performing upper limb exercises through immersive virtual reality games

ObjectiveWe aimed to assess whether individuals accept performing upper limb exercises using immersive VR games, indicated by behavioral intention, and the roles of age, self-efficacy, and technology acceptance model (TAM) constructs in the acceptance. MethodsSixty healthy participants aged 20–79 years were examined for their perceptions and acceptance of VR game-based exercises using a questionnaire. Participants were instructed to perform upper limb exercises by playing five immersive VR games in a laboratory. A theoretical model delineated the roles of the focal constructs in the acceptance was formulated and tested using path analysis. ResultsAt least 76.6% of participants (n = 46) expressed their intention to perform upper limb exercises through immersive VR games in the future. Overall, the model explained 83% variance in behavioral intention. Significant associations were observed, as follows. Age was positively associated with perceived usefulness (β = 0.27, p = 0.01), which positively influenced attitude (β = 0.64, p < 0.001); in turn, attitude positively affected behavioral intention (β = 0.84, p < 0.001). Moreover, self-efficacy positively affected perceived ease of use (β = 0.84, p < 0.001). ConclusionsFactors such as age, perceived usefulness, attitude, and self-efficacy were found to play significant roles in the acceptance of immersive VR games for upper limb exercises. In the future, strategies should be devised to meet the requirements of end users of different ages and promote usefulness, attitude, and self-efficacy in performing upper limb exercises through immersive VR games.

“You Know It’s Different in the Game Man”: Technodesiring, Technorelating, and TechnoBlackness as Analytical Modes of Queer Worldmaking in Black Mirror’s, “Striking Vipers”

ABSTRACT This article explores the reach of queer relationality beyond materiality and toward virtual realities. By expounding upon how desire, relationality, and race can be understood within technocultures, particularly within immersive interactive and virtual reality gaming, I situate the potentiality of queer worldmaking outside of the confines of social pressures and expectations in the material world. Through an analysis of Black Mirror’s episode, “Striking Vipers,” I propose three concepts for analyzing queer relationality within technocultures, technodesiring, technorelating, and technoBlackness. The article concludes with possibilities for queer relationality and queer worldmaking that extend beyond the realm of white heteropatriarchal socialities.