Immersive Virtual Reality Scenario Research Articles

The IntegraPark Study: An Opportunity to Facilitate High-Intensity Exercise with Immersive Virtual Reality in Parkinson’s Disease Patients

Background: high-intensity exercise is a feasible and effective modality in the early stages of Parkinson’s disease (PD). However, there are only a few studies that have carried out this type of intervention in customizable immersive virtual reality (IVR) environments. We explore the feasibility and effects of IVR-based high-intensity training through rowing and cycling exercises on the functional capacity, quality of life, and progression of PD. Methods: a total of 12 participants (61.50 ± 10.49 years old; 41.7% female, 58.3% male; stages I–III) were part of the study, which consisted of interventions of rowing and cycling in an IVR commercial exergame (25 min; twice per week for 14 weeks). The main variables measured were functional capacity, handgrip strength, functional mobility (TUG), functional lower-limb strength (FTSST), aerobic capacity (2-min step test), quality of life (PDQ-39), and Parkinson’s disease progression (MDS-UPDRS). Results: the results showed a general improvement in handgrip strength in both hands (p = 0.008; d = 0.28), FTSST (p = 0.029; d = 0.96), and TUG times (p = 0.152; d = 0.22). Aerobic capacity, assessed by a 2-min step test, showed enhanced scores (p = 0.031; d = 0.78). Related to the PDQ-39, all dimensions of the scale were enhanced, highlighting activities of daily living (p = 0.047; d = 0.29) and bodily discomfort (p = 0.041; d = 0.37). Finally, the main symptoms of the disease were reduced, with an improvement in the parameters that show a better incidence of disease progression, such as Part IA and IB (p = 0.013; d = 0.29 and p = 0.021; d = 0.25, respectively), Part II (p = 0.021; d = 0.23), Part III (p = 0.040; d = 0.39), and Part IV (p = 0.013; d = 0.39). Conclusions: the therapeutic exercise (rowing and cycling), when carried out at a high intensity and in a personalized IVR scenario, appear to be a feasible and safe modality for patients with stages I–III of PD, improving their functional capacity, quality of life, and disease progression.

Introducing Virtual Reality in a STEMI Coronary Syndrome Course: Qualitative Evaluation with Nurses and Doctors.

In the increasing number of medical education topics taught with virtual reality (VR), the prehospital management of ST-segment elevation myocardial infarction (STEMI) had not been considered. This article proposes an implemented VR system for STEMI training and introduces it in an institutional course addressed to emergency nurses and case manager (CM) doctors. The system comprises three different applications to, respectively, allow (a) the course instructor to control the conditions of the virtual patient, (b) the CM to communicate with the nurse in the virtual field and receive from him/her the patient's parameters and electrocardiogram, and (c) the nurse to interact with the patient in the immersive VR scenario. We enrolled 17 course participants to collect their perceptions and opinions through a semistructured interview. The thematic analysis showed the system was appreciated (n = 17) and described as engaging (n = 4), challenging (n = 5), useful to improve self-confidence (n = 4), innovative (n = 5), and promising for training courses (n = 10). Realism was also appreciated (n = 13), although with some drawbacks (e.g., oversimplification; n = 5). Overall, participants described the course as an opportunity to share opinions (n = 8) and highlight issues (n = 4) and found it useful for novices (n = 5) and, as a refresh, for experienced personnel (n = 6). Some participants suggested improvements in the scenarios' type (n = 5) and variability (n = 5). Although most participants did not report usage difficulties with the VR system (n = 13), many described the need to get familiar with it (n = 13) and the specific gestures it requires (n = 10). Three suffered from cybersickness.

Proposing immersive virtual reality scenarios for validating verbal content analysis methods in adult samples.

Verbal content analyses to differentiate truthful and fabricated statements, such as the Criteria-Based Content Analysis (CBCA), are used in lie detection research as well as in practice to assess the credibility of statements in criminal court proceedings. Meta-analyses demonstrate validity of verbal content analyses above chance, but the traditional research paradigms usually lack either ecological or internal validity. The authors discuss the usage of immersive virtual reality scenarios to solve this dilemma, as both types of validity can be increased by this approach. In this integrative review of existing literature on the current use of virtual scenarios in forensic and victimology research, the authors extract strengths and limitations for possible VR studies in the context of verbal content analysis. Furthermore, novel ethical challenges involved are summarized and implications for future studies proposed. Overall, we argue in favor of using virtual reality scenarios to validate methods for verbal content analysis, but also urge to consider ethical limitations regarding unwanted short- and long-term aftereffects.

Using immersive virtual reality technology to enhance nursing education: A comparative pilot study to understand efficacy and effectiveness

The U.S. faces a national shortage of nurses. The emergence of human-centered digital technologies has directly impacted nursing education. Using immersive Virtual Reality related digital technology to assist and enhance nurse education is promising but not yet fully understood. This study aims to understand the effectiveness and efficacy of immersive Virtual Reality nursing education approaches through a comparative pilot study. Three immersive Virtual Reality scenarios based on basic nursing skills were developed. A traditional video lecture approach including the same contents was used as a comparable approach to investigate the effectiveness and efficacy performance of the proposed immersive Virtual Reality approach. 22 participants were recruited from a college. Effectiveness was measured through motivation and knowledge gain, while efficacy was evaluated through simulation sickness, user experience, and system usability. The results showed that the VR approach has above “acceptable” efficacy performance, which indicates participants are willing to accept this novel education approach. The effectiveness results indicate that the VR approach has similar performance with the video approach in delivering nursing contents. One limitation of this investigation is that the sample size is relatively small and further larger sample sizes are needed for future analysis.

The Development and Feasibility of an Empathy Virtual Reality Scenario in Healthcare Education.

Technology-enhanced simulations such as virtual reality and computer-based experiences allow students to improve their understanding of patient perspectives and increase empathy for patients. These technologies can be daunting to nursing faculty without robust technology and video development resources. The purpose of this project was to share a guide for creating and implementing a patient-centered immersive virtual reality scenario within a nursing program. The research team developed, filmed, and produced a cost-effective virtual reality simulation scenario for use with smartphones and inexpensive virtual reality headsets, which could be widely disseminated for students to watch in class or online. The virtual reality simulation allowed an immersive first-person view and was well received by both faculty and students. The virtual reality scenario was implemented with ease in classroom, virtual, and laboratory settings. These virtual reality simulations work in the live setting or remotely, and synchronously or asynchronously with minimal equipment, which reduces barriers to access.

Phantom touch illusion, an unexpected phenomenological effect of tactile gating in the absence of tactile stimulation

We report the presence of a tingling sensation perceived during self-touch without physical stimulation. We used immersive virtual reality scenarios in which subjects touched their body using a virtual object. This touch resulted in a tingling sensation corresponding to the location touched on the virtual body. We called it “phantom touch illusion” (PTI). Interestingly, the illusion was also reported when subjects touched invisible (inferred) parts of their limb. We reason that this PTI results from tactile gating process during self-touch if there is no tactile input to supress. The reported PTI when touching invisible body parts indicates that tactile gating is not exclusively based on vision, but rather on multi-sensory, top-down input involving body schema. This supplementary finding shows that representations of one's own body are defined top-down, beyond the available sensory information.

Real and perceived feet orientation under fatiguing and non-fatiguing conditions in an immersive virtual reality environment

Lower limbs position sense is a complex yet poorly understood mechanism, influenced by many factors. Hence, we investigated the position sense of lower limbs through feet orientation with the use of Immersive Virtual Reality (IVR). Participants had to indicate how they perceived the real orientation of their feet by orientating a virtual representation of the feet that was shown in an IVR scenario. We calculated the angle between the two virtual feet (α-VR) after a high-knee step-in-place task. Simultaneously, we recorded the real angle between the two feet (α-R) (T1). Hence, we assessed whether the acute fatigue impacted the position sense. The same procedure was repeated after inducing muscle fatigue (T2) and after 10 min from T2 (T3). Finally, we also recorded the time needed to confirm the perceived position before and after the acute fatigue protocol. Thirty healthy adults (27.5 ± 3.8: 57% women, 43% men) were immersed in an IVR scenario with a representation of two feet. We found a mean difference between α-VR and α-R of 20.89° [95% CI: 14.67°, 27.10°] in T1, 16.76° [9.57°, 23.94°] in T2, and 16.34° [10.00°, 22.68°] in T3. Participants spent 12.59, 17.50 and 17.95 s confirming the perceived position of their feet at T1, T2, T3, respectively. Participants indicated their feet as forwarding parallel though divergent, showing a mismatch in the perceived position of feet. Fatigue seemed not to have an impact on position sense but delayed the time to accomplish this task.

Point cloud quality assessment based on geometry-aware texture descriptors

In recent years, 3D imaging technologies have advanced tremendously, allowing more faithful representations of the physical world. More specifically, imaging technology advancements have driven the production of plenoptic devices that can capture and display visual contents. These devices represent the visual data using an approximation of the plenoptic illumination function, which can describe visible objects in any position and from any point-of-view of the 3D space. Depending on the capturing device, this approximation can correspond to holograms, light fields, or Point Clouds (PCs) imaging formats. Among these formats, PCs have become very popular for a wide range of applications, such as immersive virtual reality scenarios. As a consequence, in the last couple of years, there has been a great effort to develop novel acquisition, representation, compression, and transmission solutions for PC contents in the research community. In particular, the development of objective quality assessment methods that are able to predict the perceptual quality of PCs has attracted a lot of attention. In this paper, we present an effective framework for assessing the quality of PCs, which is based on descriptors that extract geometry-aware texture information of PC contents. In this framework, the statistics of the extracted information are used to model the PC visual quality. We also present the research and experiments carried to evaluate the most appropriate distance metrics and regression methods to be used together with the proposed descriptors. Experimental results show that the proposed framework exhibit good and robust performance when compared with several state-of-the-art Point Cloud Quality Assessment (PCQA) methods. A C++ implementation of the metrics described in this paper can be found at https://gitlab.com/gpds-unb/pc_metric.

See it, hear it, feel it: embodying a patient experience through immersive virtual reality

PurposeThe aim of the study was to explore aspects of learning in terms of gain in knowledge, confidence and empathy with immersive virtual reality (VR) from the patient perspective in undergraduate nursing students.Design/methodology/approachA pilot study integrating immersive VR experiences during clinical courses was facilitated based on the INACSL (2016) standards for simulation practices with a convenience sample of 165 nursing students in three levels of cohorts, using two different VR scenario simulations. Quantitative and qualitative data were collected through pre- and post-surveys.FindingsStudent participants embodied patients with chronic disease using immersive VR. Findings showed substantial gains in most measures of knowledge, confidence and empathy, with slightly less difference seen in lower level nursing students particularly with empathy and understanding.Research limitations/implicationsEmbodiment through immersive VR scenarios was shown to increase learner development. The positive findings from the pilot study justified continuance of integration of immersive VR in nursing education, recommending further use and research.Originality/valueSimulated learning for nursing has known benefits on knowledge and understanding. Immersive VR is gaining recognition within nursing education as a method to enhance cognitive and affective knowledge. This paper hopes to add insights on the impact of immersive VR for student learning and encourage discussion about the future for innovative immersive teaching and learning approaches for experiential learning.

A novel point cloud quality assessment metric based on perceptual color distance patterns

In recent years, PCs have become very popular for a wide range of applications, such as immersive virtual reality scenarios. As a consequence, in the last couple of years, there has been a great effort to develop novel acquisition, representation, compression, and transmission solutions for PC contents in the research community. In particular, the development of objective quality assessment methods that are able to predict the perceptual quality of PCs. In this paper, we present an effective novel method for assessing the quality of PCs, which is based on descriptors that extract perceptual color distance-based texture information of PC contents, called Perceptual Color Distance Patterns (PCDP). In this framework, the statistics of the extracted information are used to model the PC visual quality. Experimental results show that the proposed framework exhibit good and robust performance when compared with several state-of-the-art point cloud quality assessment (PCQA) methods.

Integrating Virtual Reality and GIS Tools for Geological Mapping, Data Collection and Analysis: An Example from the Metaxa Mine, Santorini (Greece)

In the present work we highlight the effectiveness of integrating different techniques and tools for better surveying, mapping and collecting data in volcanic areas. We use an Immersive Virtual Reality (IVR) approach for data collection, integrated with Geographic Information System (GIS) analysis in a well-known volcanological site in Santorini (Metaxa mine), a site where volcanic processes influenced the island’s industrial development, especially with regard to pumice mining. Specifically, we have focused on: (i) three-dimensional (3D) high-resolution IVR scenario building, based on Structure from Motion photogrammetry (SfM) modeling; (ii) subsequent geological survey, mapping and data collection using IVR; (iii) data analysis, e.g., calculation of extracted volumes, as well as production of new maps in a GIS environment using input data directly from the IVR survey; and finally, (iv) presentation of new outcomes that highlight the importance of the Metaxa Mine as a key geological and volcanological geosite.

Immersive Virtual Reality Medical Simulation: Autonomous Trauma Training Simulator.

BackgroundMedical and traumatic emergencies can be intimidating and stressful. This is especially true for early-career medical personnel.Training providers to respond effectively to medical emergencies before being confronted with a real scenario is limited by unnatural or high-cost training modalities that fail to realistically replicate the stress and gravity of real-world trauma management. Immersive virtual reality (IVR) may provide a unique training solution. MethodsWe created a working group of 10 active duty or former military emergency medicine physicians and two technical experts. We hosted 10 meetings to facilitate the development process. The program was developed with financial support from the Telemedicine and Advanced Technology Research Center (TATRC), through the primary vendor Exonicus, Inc, with support from Anatomy Next Inc, and Kitware, Inc. Development was completed using an agile project management style, which allowed our team to review progress and provide immediate feedback on previous milestones throughout its completion. The working group completed the resulting four simulation scenarios to evaluate perceived realism and training potential. Finally, testing of the technology platform off the network in a deployed role 3 was conducted.ResultsUpon completion, we created four IVR scenarios based on the highest mortality battlefield injuries: hemorrhage, tension pneumothorax, and airway obstruction. The working group unanimously indicated a high level of realism and potential training usefulness. Throughout this process, there have been a number of lessons learned and we present those here to show what we have created as well as provide guidance to others creating IVR training solutions. ConclusionOur team developed trauma scenarios that, to our knowledge, are the only IVR trauma scenarios to run autonomously without instructor input. Furthermore, we provide a potential template for the creation of future autonomous IVR training programs. This framework may offer a dynamic starting point as more teams seek to leverage the capabilities IVR offers.

77 Virtual Reality Trauma Simulation: An Immersive Method to Enhance Medical Personnel Training and Readiness

Immersive virtual reality (IVR) can be highly effective as a medical simulation training platform. Given recent advancements this technology has become increasingly portable and visually realistic. While IVR technology appears to hold promise, there is a great deal to learn about the best way to functionally develop, implement, and share these training resources. Several groups have created models that recreate current simulation lab environments with instructor input. While these systems increase training opportunities, decrease equipment needs, and offer broad potential, they still require a skilled trainer to ‘prompt the system.’ Removing this limitation seems like a potential way to increase scalability. We are currently in the process of creating, to our knowledge, the only simulator that would offer immediate autonomous feedback to users through both real-time patient physiologic responses and overall grading. We created a working group of 10 active duty or former military emergency physicians and 2 technical experts. We hosted 15 meetings to facilitate the development process. The program was developed with financial support from the Telemedicine and Advanced Technology Research Center (TATRC), through the primary vendor Exonicus, Inc, with support from Anatomy Next Inc, and Kitware, Inc. Development was completed using an agile project management style, which allowed our team to review progress and provide immediate feedback on previous milestones throughout its completion. The working group completed the resulting 4 simulation scenarios to evaluate perceived realism and training potential. Finally, while one member of the team was deployed, testing of the technology platform off the network in a deployed role 3/tent environment was conducted. Upon completion we created four IVR scenarios based on the highest mortality battlefield injuries: hemorrhage, tension pneumothorax, and airway obstruction. The working group unanimously indicated a high level of realism and potential training usefulness. Throughout this process there have been a number of lessons learned and we present those here to show what we have created as well as provide guidance to others creating IVR training solutions. Our team developed trauma scenarios that, to our knowledge, are the only IVR trauma scenarios to run autonomously without instructor input. Furthermore, we provide a potential template for the creation of future autonomous IVR training programs. This framework may offer a dynamic starting point as more teams seek to leverage the capabilities IVR offers.

The experience of virtual reality: are individual differences in mental imagery associated with sense of presence?

The concept of "presence" describes the quality of subjective experience in immersive virtual reality (IVR). Presence refers to a specific state of consciousness: we behave and feel as if we actually were in the virtual world even though we know there is nothing there. In their handbook of Virtual Reality, Burdea and Coiffet (Virtual reality technology, Wiley, New York, 2003) suggested that the experience of presence in IVR would emerge from the combination of three Is: Immersion or capacity to isolate from the external world, Interaction or capacity to naturally exploring the virtual environment, and Imagination or individual aptitudes with mental imagery. So far, several studies have investigated the technological and psychological factors affecting the degree of immersion and interaction. However, no study has explored the relationship between perceived presence and mental imagery. Here we aim at filling this gap through a correlational study comparing self-reports about sense of presence and mental imagery abilities. After experiencing two IVR scenarios (an art gallery and a living room), 142 male and female users were administered with questionnaires assessing the degree of presence (Igroup Presence Questionnaire), the degree of vividness (Vividness of Visual Imagery Questionnaire) and control (Test of Visual Imagery Control) of subjective mental images. Results showed a clear positive correlation between presence and vividness: the higher the vividness of mental images the stronger the reported sense of presence felt in IVR scenarios. Instead, the capacity to control mental imagery showed a weaker association with presence. We may conclude that individual differences in the degree of perceived presence and mental imagery ability are associated.

A Three Revolute-Revolute-Spherical Wearable Fingertip Cutaneous Device for Stiffness Rendering.

We present a novel three Revolute-Revolute-Spherical (3RRS) wearable fingertip device for the rendering of stiffness information. It is composed of a static upper body and a mobile end-effector. The upper body is located on the nail side of the finger, supporting three small servo motors, and the mobile end-effector is in contact with the finger pulp. The two parts are connected by three articulated legs, actuated by the motors. The end-effector can move toward the user's fingertip and rotate it to simulate contacts with arbitrarily-oriented surfaces. Moreover, a vibrotactile motor placed below the end-effector conveys vibrations to the fingertip. The proposed device weights 25g for 35 x 50 x 48 mm dimensions. To test the effectiveness of our wearable haptic device and its level of wearability, we carried out two experiments, enrolling 30 human subjects in total. The first experiment tested the capability of our device in differentiating stiffness information, while the second one focused on evaluating its applicability in an immersive virtual reality scenario. Results showed the effectiveness of the proposed wearable solution, with a JND for stiffness of 208.5 17.2N/m. Moreover, all subjects preferred the virtual interaction experience when provided with wearable cutaneous feedback, even if results also showed that subjects found our device still a bit difficult to use.

Influence of Music on Anxiety Induced by Fear of Heights in Virtual Reality.

Music is a potent mood regulator that can induce relaxation and reduce anxiety in different situations. While several studies demonstrate that certain types of music have a subjective anxiolytic effect, the reported results from physiological responses are less conclusive. Virtual reality allows us to study diverse scenarios of real life under strict experimental control while preserving high ecological validity. We aimed to study the modulating effect of music on the anxiety responses triggered by an immersive virtual reality scenario designed to induce fear of heights. Subjects experienced a virtual scenario depicting an exterior elevator platform ascending and descending the total height of its 350 meters tall supporting structure. Participants were allocated to either a group that experienced the elevator ride with background music or without, in a between-groups design. Furthermore, each group included participants with different degrees of fear of heights, ranging from low to high fear. Recordings of heart rate, galvanic skin response, body balance, and head movements were obtained during the experiments. Subjective anxiety was measured by means of three questionnaires. The scenario produced significant changes in subjective and physiological measures, confirming its efficacy as a stressor. A significant increase in state anxiety was found between pre and post-assessment in the silence group, but not in the music group, indicating that post-stress recovery was faster in the musical group. Results suggest that music can ameliorate the subjective anxiety produced by fear of heights.

Sounding fire for immersive virtual reality

Both visual information and sound are required in immersive virtual reality. This paper proposes a computational method for fast synthesis of plausible fire sound that is synchronized with physically based fire animations. We divide fire sound into two parts: low frequency and mid- to high frequency, and use two processes to separately synthesize these two parts. By simplifying calculations using a novel combustion sound model as well as leveraging GPU parallel computing in a marching-cube-like manner, our method speeds up the computation of low-frequency part by an order of magnitude. To run the time-stepping fire simulation at a relative low frequency rather than the audio rate, we add synchronized mid- and high-frequency wavelet details to low-frequency simulation contents with a post-process to generate complete fire sound. We validated our method with various experiments to build a solid physically based basis for real-time acoustic rendering that can be used for immersive virtual reality scenarios.

Motor resources in peripersonal space are intrinsic to spatial encoding: Evidence from motor interference

The aim of this study was to explore the role of motor resources in peripersonal space encoding: are they intrinsic to spatial processes or due to action potentiality of objects? To answer this question, we disentangled the effects of motor resources on object manipulability and spatial processing in peripersonal and extrapersonal spaces. Participants had to localize manipulable and non-manipulable 3-D stimuli presented within peripersonal or extrapersonal spaces of an immersive virtual reality scenario. To assess the contribution of motor resources to the spatial task a motor interference paradigm was used. In Experiment 1, localization judgments were provided with the left hand while the right dominant arm could be free or blocked. Results showed that participants were faster and more accurate in localizing both manipulable and non-manipulable stimuli in peripersonal space with their arms free. On the other hand, in extrapersonal space there was no significant effect of motor interference. Experiment 2 replicated these results by using alternatively both hands to give the response and controlling the possible effect of the orientation of object handles. Overall, the pattern of results suggests that the encoding of peripersonal space involves motor processes per se, and not because of the presence of manipulable stimuli. It is argued that this motor grounding reflects the adaptive need of anticipating what may happen near the body and preparing to react in time.