Simulator Sickness Research Articles

The study of exercise therapy using a virtual reality system on healthy subjects assuming hospital use and intradialytic exercise.

This study aimed to investigate the basic data on the effectiveness and safety of the system in healthy subjects using an immersive virtual reality (VR) exercise system specialized for therapeutic exercise therapy during dialysis or hospital use. A total of 15 healthy adult subjects performed four exercises, namely lifting and rowing exercises using VR and each movement exercise without VR (control). The simulator sickness questionnaire (SSQ) was administered pre- and post-operatively to assess for VR sickness. Blood pressure, heart rate (HR), rating of perceived exhaustion, Profile of Mood States 2nd Edition Japanese version, and muscle activity (iEMG) were measured using electromyography. The correlation between changes in mood states and HR or iEMG results was examined. The SSQ measured post-VR exercise was 11.2 (18.7-7.5) and 11.2 (7.5-29.9) points in the lifting and rowing VR, respectively. The HR in lifting (VR, 82.5 ± 12.7 vs control, 71.6 ± 10.6 bpm, P<0.05) and rowing (VR, 94.2 ± 13.1 vs control, 83.5 ± 12.0, P<0.05) with VR exercise was significantly higher than in control. No significant differences were observed between the other variables. There was a positive correlation between HR and negative mood in the lifting VR condition (r=0.64, P<0.05), but not in the control group. Contrastingly, there was a positive correlation between iEMG and negative mood in rowing control (r=0.56), but not VR. Safety was confirmed, with no VR sickness or discontinuation of the system. Exercise therapy using VR resulted in a higher exercise load. This VR system has the potential for additional effective intradialytic exercises and hospital use.

Effects of virtual reality guided meditation in older adults: the protocol of a pilot randomized controlled trial.

Virtual reality (VR) based meditation has been shown to help increase relaxation and decrease anxiety and depression in younger adults. However, this has not been studied in Randomized Controlled Trials (RCT) in the older adult population. The aim of this RCT is to assess the feasibility and acceptability of a VR-guided meditation intervention for community-dwelling older adults and its effect on stress and mental health. We will recruit 30 participants aged ≥ 60 years, whose perceived stress score (PSS) is > 14 (moderate stress), and randomize them 1:1 to the intervention or control waitlist group. The intervention will involve exposure to eight 15-min VR-guided meditation sessions distributed twice weekly for 4-weeks. Two modalities will be offered: in-home and at the hospital. Baseline and post-intervention assessments will evaluate perceived stress, anxiety, depression, sleep quality, quality of life, and mindfulness skills. Analyses will employ mixed methods repeated ANOVA tests. Qualitative analyses through semi-structured interviews and participant observation will be used to assess participants' experiences. Study outcomes include: (A) feasibility and acceptability compared to a waitlist control (B) stress, using the Perceived Stress Scale (PSS); (C) anxiety, and depression, using the Generalized Anxiety Disorder-7 (GAD-7) and Patient Health Questionnaire-9 (PHQ-9); (D) insomnia, quality of life and mindfulness skills, using the Athens Insomnia Scale (AIS), Quality of Life Questionnaire (EQ-5D-5L) and Five Facets Mindfulness Questionnaire Short Forms (FFMQ-SF), respectively. We will also measure immersive tendencies, sickness and sense of presence using the Simulator Sickness Questionnaire (SSQ) and the Presence Questionnaire (PQ). Virtual reality-guided meditation could be an acceptable, feasible, safe, and cost-effective novel alternative health intervention for improving older adults' mental health.Clinical trial registration: NCT05315609 at https://clinicaltrials.gov.

Tolerance of immersive head-mounted virtual reality among older nursing home residents.

Virtual Reality (VR) is a tool that is increasingly used in the aging population. Head-Mounted Displays (HMDs) are stereoscopic vision devices used for immersive VR. Cybersickness is sometimes reported after head-mounted display (HMD) VR exposure. Cybersickness severity and anxiety state reflect VR low tolerance. We aimed to evaluate HMD VR tolerance among older nursing home residents through cybersickness and anxiety state. A total of 36 participants were included in this preliminary study, 33 of whom (mean age: 89.33 ± 5.48) underwent three individual HMD VR sessions with three different contents. Cybersickness occurrence and severity were scored by the Simulator Sickness Questionnaire (SSQ) after each session. Anxiety state was assessed by the State-Trait Anxiety Inventory form Y-A before and after each session. Anxiety trait (using State-Trait Anxiety Inventory form Y-B) was also evaluated before and after the experiment. In total, 92% (33/36) of patients completed all three sessions, of which 61% (20/33) did not report any cybersickness symptoms (SSQ = 0). Six participants reported significant cybersickness (defined by an SSQ score ⩾10) in at least one session. Only two participants stopped the study after the first exposure because of cybersickness. Age, cognitive function, anxiety trait, and well-being were not associated with cybersickness. The mean anxiety state decreased significantly from pre- to post-session. This immersive HMD VR experience was well tolerated among nursing home dwellers. Further larger studies in this population aiming to identify CS determinants are needed in order to use HMD VR on a standard basis.

Fully immersive virtual reality exergames with dual-task components for patients with Parkinson’s disease: a feasibility study

BackgroundDual-task training in Parkinson’s disease (PD) improves spatiotemporal gait parameters, cognition, and quality of life. Virtual reality (VR) has been used as a therapeutic tool for patients to participate in activities in a safe environment, engage in multisensory experiences, and improve motivation and interest in rehabilitation. This study aimed to investigate the feasibility of fully immersive VR exergames with dual-task components in patients with PD.MethodsWe developed VR exergames (go/no-go punch game, go/no-go stepping game, and number punch game) to improve habitual behavior control using motor–cognitive dual-task performance in patients with PD. The participants underwent 10 sessions 2–3 times a week, consisting of 30 min per session. The Unified Parkinson’s Disease Rating Scale, Timed Up and Go test (TUG) under single- and dual-task (cognitive and physical) conditions, Berg balance scale (BBS), Stroop test, trail-making test, and digit span were evaluated before and after intervention. The Simulator Sickness Questionnaire (SSQ) was used to assess VR cybersickness. Usability was assessed using a self-reported questionnaire.ResultsTwelve patients were enrolled and completed the entire training session. The mean age of participants was 73.83 ± 6.09 years; mean disease duration was 128.83 ± 76.96 months. The Hoehn and Yahr stages were 2.5 in seven patients and 3 in five patients. A significant improvement was observed in BBS and Stroop color–word test (p = 0.047 and p = 0.003, respectively). TUG time and dual-task interferences showed positive changes, but these changes were not statistically significant. The median SSQ total score was 28.05 (IQR: 29.92), 13.09 (IQR: 11.22), and 35.53 (IQR: 52.36) before, after the first session, and after the final session, respectively; the differences were not significant. Overall satisfaction with the intervention was 6.0 (IQR: 1.25) on a 7-point Likert-type scale.ConclusionsFully immersive VR exergames combined with physical and cognitive tasks may be used for rehabilitation of patients with PD without causing serious adverse effects. Furthermore, the exergames using dual-task components improved executive function and balance. Further development of VR training content may be needed to improve motor and dual-task performances.Trial registration NCT04787549 (https://clinicaltrials.gov/ct2/show/NCT04787549)

Cybersickness Response among Nursing Students in using Virtual Reality: A Pre-Experimental Study

The rapid growth of information and communication technology, such as virtual reality, affects students’ learning outcomes and their success in providing health services in the future. However, prolonged use of immersive technology could lead to health problems due to repetitive interaction with hardware devices, resulting in a sensory conflict called cybersickness. This study aimed to identify the cybersickness response among nursing students in using virtual reality. This research used a pre-experiment design, and a total of 49 nursing students participated. The Simulator Sickness Questionnaire was used to assess cybersickness and physiological responses. The data were analyzed using the Wilcoxon signed-rank test. The median post-test values for the three components (nausea, oculomotor, disorientation) in cybersickness were 28.7; 45.5; 83.6; and 606.1, respectively. We found statistically significant differences in cybersickness between pre- and post-intervention periods (p &lt; .001). Heart rate and body temperature increased significantly (p &lt; .001; p &lt; .001, respectively), while in both systolic and diastolic blood pressure decreased (p &lt; .001). According to the findings, using VR as an alternative learning media could initiate cybersickness on a certain level. Thus, the physiological response would be different for each participant.

DreamWalk: Dynamic remapping and multiperspectivity for large‐scale redirected walking

SummaryRedirected walking (RDW) provides an immersive user experience in virtual reality applications. In RDW, the size of the physical play area is limited, which makes it challenging to design the virtual path in a larger virtual space. Mainstream RDW approaches rigidly manipulate gains to guide the user to follow predetermined rules. However, these methods may cause simulator sickness, boundary collision, and reset. Static mapping approaches warp the virtual path through expensive vertex replacement in the stage of model pre‐processing. They are restricted to narrow spaces with non‐looping pathways, partition walls, and planar surfaces. These methods fail to provide a smooth walking experience for large‐scale open scenes. To tackle these problems, we propose a novel approach that dynamically redirects the user to walk in a non‐linear virtual space. More specifically, we propose a Bezier‐curve‐based mapping algorithm to warp the virtual space dynamically and apply multiperspective fusion for visualization augmentation. We conduct comparable experiments to show its superiority over state‐of‐the‐art large‐scale redirected walking approaches on our self‐collected photogrammetry dataset.

Frequency-dependent tuning of the human vestibular “sixth sense” by transcranial oscillatory currents

ObjectiveThe vestibular cortex is a multisensory associative region that, in neuroimaging investigations, is activated by slow-frequency (1–2 Hz) galvanic stimulation of peripheral receptors. We aimed to directly activate the vestibular cortex with biophysically modeled transcranial oscillatory current stimulation (tACS) in the same frequency range. MethodsThirty healthy subjects and one rare patient with chronic bilateral vestibular deafferentation underwent, in a randomized, double-blind, controlled trial, to tACS at slow (1 or 2 Hz) or higher (10 Hz) frequency and sham stimulations, over the Parieto-Insular Vestibular Cortex (PIVC), while standing on a stabilometric platform. Subjective symptoms of motion sickness were scored by Simulator Sickness Questionnaire and subjects’ postural sways were monitored on the platform. ResultstACS at 1 and 2 Hz induced symptoms of motion sickness, oscillopsia and postural instability, that were supported by posturographic sway recordings. Both 10 Hz-tACS and sham stimulation on the vestibular cortex did not affect vestibular function. As these effects persisted in a rare patient with bilateral peripheral vestibular areflexia documented by the absence of the Vestibular-Ocular Reflex, the possibility of a current spread toward peripheral afferents is unlikely. Conversely, the 10 Hz-tACS significantly reduced his chronic vestibular symptoms in this patient. ConclusionsWeak electrical oscillations in a frequency range corresponding to the physiological cortical activity of the vestibular system may generate motion sickness and postural sways, both in healthy subjects and in the case of bilateral vestibular deafferentation. SignificanceThis should be taken into account as a new side effect of tACS in future studies addressing cognitive functions. Higher frequencies of stimulation applied to the vestibular cortex may represent a new interventional option to reduce motion sickness in different scenarios.

Subjective Visual Vertical test with the 3D virtual reality system: effective factors and cybersickness

Background 3D Virtual Reality (VR) offers new opportunities in vestibular science. It also presents new challenges and problems. Aims/objectives The study aimed to evaluate the effective factors in the 3D VR Subjective Visual Vertical (SVV) test and the impact of cybersickness on the test results. Material and methods The effect of the foam surface, head position in the yaw axis, moving background, and arm position holding the controller was tested. Cybersickness was evaluated using the Simulator Sickness Questionnaire (SSQ). Results The head position and controller holding style significantly affected the results. The foam surface and the moving background did not have a significant effect. Although 61.4% of the patients fell into the bad category according to the symptoms of the SSQ score, cybersickness did not significantly affect the SVV results. Conclusions and significance In 3D VR SVV, additional factors should be considered: the headset’s weight, head position, and how we hold the controller. The A-effect emerged when the head was 45 degrees turned on the yaw axis. A significant shift was detected in the test, with the arm holding the controller at 90 degrees. Most subjects felt cybersickness at a considerable level. Cybersickness should always be taken into account in VR when planning new applications.

EFFECTS OF IMMERSIVE VIRTUAL REALITY IN ENHANCING CREATIVITY

AbstractIn recent years, the use of virtual reality (VR) has been a promising opportunity to improve the immersive experience in virtual environments. In this study, we explore the effectiveness of immersive VR experiences on an individual's creativity. To do this, we first identified the characteristics of VR that are closely related to creative performance. Considering these factors, we designed and implemented the interaction method and the three outdoor and indoor virtual environments (Wilderness, City Park, and Office). We evaluated the effectiveness of the virtual environments with 12 participants. The user study results show that outdoor and indoor immersive virtual experiences improved their creativity skills. We concluded by analysing how factors such as simulator sickness and perceived workload influence creativity levels. Moreover, our study showed the potentiality of using immersive virtual environments to enhance individuals’ creative performance.

Real-Time Prediction of Simulator Sickness in Virtual Reality Games

Virtual Reality (VR) technology has progressed rapidly and is used in various domains, particularly games. Simulator Sickness (SS) still represents a significant problem for its wider adoption. The most common way to detect SS is using the Simulator Sickness Questionnaire (SSQ). SSQ is a subjective measurement and is inadequate for real-time applications such as VR games. This research aims to develop a model to predict SS in real time using in-game characters&#x2019; movement and users&#x2019; eye motion data during gameplay in VR games. To achieve this, we designed an experiment to collect such data with three types of games. We trained a Long Short-Term Memory neural network with the eye-tracking and character movement data to predict SS. Our model can predict SS in real time with an accuracy of 83.4% for players who suffer from severe sensitivity to SS. Our results indicate that, in VR games, our model is an accurate and efficient method to predict SS in real time.

71‐2: Effect of Compensation Method on Visually Induced Motion Sickness for Transparent Window Display

An information compensation method to reduce motion sickness caused by reading information on the transparent window display has been studied and proposed. In this research, Visual Analogue Scale (VAS), Center of Pressure(CoP), Simulator sickness questionnaire (SSQ) and Heart Rate Variability (HRV) were conducted and the data analysis revealed that the information compensation based on the degree of vehicle vibration improved the comfort of reading the text information for passengers.

Virtual Reality Simulation for Suicide Risk Assessment Training: Prevalence of Adverse Effects.

Virtual reality (VR) simulation is changing the landscape of simulation-based medical education. Immersive VR allows users to interact with a computer-generated environment and digital avatars using a VR headset and controllers. However, current literature regarding the use of immersive VR simulation in psychiatric medical education is sparse. This study describes its use and considerations regarding tolerability. At a mental health hospital in Canada, two immersive VR suicide risk assessment (SRA) case simulations were developed. These simulations have participants interview VR patients to characterize their suicide risk, offering a novel and safe way to engage healthcare providers in SRA training. Regarding user tolerability of these VR simulations, the Simulator Sickness Questionnaire (SSQ) was administered to participants after the simulation to characterize any motion sickness symptoms experienced. Of the 22 participants in this study, the overall SSQ scores demonstrated good tolerability of the VR SRA, with the majority of participants reporting no or minimal simulator sickness symptoms. Moreover, the majority of participants reported being satisfied with this training and that the VR SRA simulation enhanced their learning experience. These study findings are novel, given the current dearth of data regarding the use of immersive VR in simulation-based psychiatric medical education. Further studies exploring the educational effectiveness of VR SRA in simulation-based psychiatric medical education are indicated.

THE INCIDENCE OF SIMULATOR SICKNESS IN PILOTS AND NON-PILOTS EXPOSED TO SPATIAL DISORIENTATION EVENTS IN THE GYRO-IPT SIMULATOR

Introduction: A previous study conducted in the Gyro-IPT simulator revealed that applied flight scenarios induced minor severity of simulator sickness symptoms in participants. In this study, however, we did not investigate how the severity of symptoms differs between pilots and non-pilots. Therefore, the presented study aimed to examine whether the symptoms of simulator sickness induced in pilots and non-pilots during spatial disorientation (SD) training are significantly different. We were particularly interested in whether the standard flight scenario used in SD training could be a contributing factor in increasing simulator sickness in novice, inexperienced pilots. Method: We used the data from the previous study, where twenty male military pilots (age 31.6 ±8.22) with flight experience (total flight hours 1300 ±1167.4) and 20 non-pilots (age 30.9 ±7.72) were assigned to one of two groups and then exposed to a 1-hour long flight session (12 flight profiles, six involved an SD-conflict) with active control in the Gyro IPT simulator. To measure simulator sickness symptoms, the Simulator Sickness Questionnaire (SSQ) was administered pre and post-simulator exposure. In the presented study, the SSQ scores were analyzed independently for the total SSQ and subscores for nausea, oculomotor, and disorientation, and then were compared between groups. Results: The score of the total severity and for each subscale of SSQ symptoms in the non-pilots‘ group were higher than those in the pilots group, however, these differences were not significant. Despite the observed differences, according to the SSQ scoring criteria the simulator sickness symptoms reported by the participants after exposure to the applied flight scenario were negligible. Conclusion: The flight scenarios used in SD training did not generate significantly different symptoms of simulator sickness between non-pilots and pilots. The low level of severity of simulator sickness symptoms in these two study groups may indicate difficulty in predicting simulator sickness based on SSQ only.

Virtual reality in medical emergencies training: benefits, perceived stress, and learning success

Medical graduates lack procedural skills experience required to manage emergencies. Recent advances in virtual reality (VR) technology enable the creation of highly immersive learning environments representing easy-to-use and affordable solutions for training with simulation. However, the feasibility in compulsory teaching, possible side effects of immersion, perceived stress, and didactic benefits have to be investigated systematically. VR-based training sessions using head-mounted displays alongside a real-time dynamic physiology system were held by student assistants for small groups followed by debriefing with a tutor. In the pilot study, 36 students rated simulation sickness. In the main study, 97 students completed a virtual scenario as active participants (AP) and 130 students as observers (OBS) from the first-person perspective on a monitor. Participants completed questionnaires for evaluation purposes and exploratory factor analysis was performed on the items. The extent of simulation sickness remained low to acceptable among participants of the pilot study. In the main study, students valued the realistic environment and guided practical exercise. AP perceived the degree of immersion as well as the estimated learning success to be greater than OBS and proved to be more motivated post training. With respect to AP, the factor “sense of control” revealed a typical inverse U-shaped relationship to the scales “didactic value” and “individual learning benefit”. Summing up, curricular implementation of highly immersive VR-based training of emergencies proved feasible and found a high degree of acceptance among medical students. This study also provides insights into how different conceptions of perceived stress distinctively moderate subjective learning success.

Immersive Virtual Reality Reaction Time Test and Relationship with the Risk of Falling in Parkinson's Disease.

Immersive virtual reality (IVR) uses customized and advanced software and hardware to create a digital 3D reality in which all of the user's senses are stimulated with computer-generated sensations and feedback. This technology is a promising tool that has already proven useful in Parkinson's disease (PD). The risk of falls is very high in people with PD, and reaction times and processing speed may be markers of postural instability and functionality, cognitive impairment and disease progression. An exploratory study was conducted to explore the feasibility of reaction time tests performed in IVR as predictors of falls. A total of 26 volunteers (79.2% male; 69.73 ± 6.32 years) diagnosed with PD (1.54 ± 0.90 H&Y stage; 26.92 ± 2.64 MMSE) took part in the study. IVR intervention was feasible, with no adverse effects (no Simulator Sickness Questionnaire symptoms). IVR reaction times were related (Spearman's rho) to functionality (timed up and go test (TUG) (rho = 0.537, p = 0.005); TUG-Cognitive (rho = 0.576, p = 0.020); cognitive impairment mini mental state exam (MMSE) (rho = -0.576, p = 0.002)) and the years of the patients (rho = 0.399, p = 0.043) but not with the first PD symptom or disease stage. IVR test is a complementary assessment tool that may contribute to preventing falls in the proposed sample. Additionally, based on the relationship between TUG and reaction times, a cut-off time is suggested that would be effective at predicting the risk of suffering a fall in PD patients using a simple and quick IVR test.

Effect of Frame Rate on User Experience, Performance, and Simulator Sickness in Virtual Reality.

The refresh rate of virtual reality (VR) head-mounted displays (HMDs) has been growing rapidly in recent years because of the demand to provide higher frame rate content as it is often linked with a better experience. Today's HMDs come with different refresh rates ranging from 20Hz to 180Hz, which determines the actual maximum frame rate perceived by users' naked eyes. VR users and content developers often face a choice because having high frame rate content and the hardware that supports it comes with higher costs and other trade-offs (such as heavier and bulkier HMDs). Both VR users and developers can choose a suitable frame rate if they are aware of the benefits of different frame rates in user experience, performance, and simulator sickness (SS). To our knowledge, limited research on frame rate in VR HMDs is available. In this paper, we aim to fill this gap and report a study with two VR application scenarios that compared four of the most common and highest frame rates currently available (60, 90, 120, and 180 frames per second (fps)) to explore their effect on users' experience, performance, and SS symptoms. Our results show that 120fps is an important threshold for VR. After 120fps, users tend to feel lower SS symptoms without a significant negative effect on their experience. Higher frame rates (e.g., 120 and 180fps) can ensure better user performance than lower rates. Interestingly, we also found that at 60fps and when users are faced with fast-moving objects, they tend to adopt a strategy to compensate for the lack of visual details by predicting or filling the gaps to try to meet the performance needs. At higher fps, users do not need to follow this compensatory strategy to meet the fast response performance requirements.

Identifying Strategies to Mitigate Cybersickness in Virtual Reality Induced by Flying with an Interactive Travel Interface

As Virtual Reality (VR) technology has improved in hardware, accessibility of development and availability of applications, its interest has increased. However, the problem of Cybersickness (CS) still remains, causing uncomfortable symptoms in users. Therefore, this research seeks to identify and understand new CS mitigation strategies that can contribute to developer guidelines. Three hypotheses for strategies were devised and tested in an experiment. This involved a physical travel interface for flying through a Virtual Environment (VE) as a Control (CT) condition. On top of this, three manipulation conditions referred to as Gaze-tracking Vignette (GV), First-person Perspective with members representation (FP) and Fans and Vibration (FV) were applied. The experiment was between subjects, with 37 participants randomly allocated across conditions. According to the Simulator Sickness Questionnaire (SSQ) scores, significant evidence was found that GV and FP made CS worse. Evidence was also found that FV did not have an effect on CS. However, from the physiological data recorded, an overall lowering of heart rate for FV indicated that it might have some effect on the experience, but cannot be strongly linked with CS. Additionally, comments from some participants identified that they experienced symptoms consistent with CS. Amongst these, dizziness was the most common, with a few having issues with the usability of the travel interface. Despite some CS symptoms, most participants reported little negative impact of CS on the overall experience and feelings of immersion.

Fusing the Virtual and Physical Worlds to Identify Declines in Instrumental Activities of Daily Living Associated with Parkinson’s Disease (S37.008)

<h3>Objective:</h3> The objective of this study was to utilize a novel virtual reality paradigm, Cleveland Clinic Virtual Reality Shopping (CC-VRS), to identify changes in instrumental activities of daily living (IADL) associated with Parkinson’s disease (PD). <h3>Background:</h3> Understanding the effects of medication or surgical interventions on PD IADL performance is necessary to ensure optimized function and maximize independence. The CC-VRS combines virtual reality content with an omnidirectional treadmill to create an immersive full-scale grocery shopping environment that presents cognitive and physical challenges, objectively and quantitatively evaluating cognitive and motor function. <h3>Design/Methods:</h3> Fourteen individuals with PD (UPDRS-III 25.9 ± 13.9, ON antiparkinsonian medication), and 14 age- and gender-matched healthy adults completed Basic and Complex shopping scenarios; the latter includes additional cognitive and physical demands while shopping. During the scenario, participants physically navigated through the virtual grocery store on the omnidirectional treadmill that allowed them to walk in a straight line and perform 90° and 180° turns. The store route, shopping items, and distractors were standardized across participants. <h3>Results:</h3> Motor and cognitive performance differed across PD and control groups. From a motor perspective, PD patients exhibited significantly shorter step length (<i>p</i>&lt;0.05) and experienced multiple freezing episodes while turning. Cognitive function was evaluated through list observation behaviors; PD patients spent significantly more time looking at their virtual shopping list (<i>p</i>&lt;0.01) and time for each list activation was nearly twice that of controls (<i>p</i>&lt;0.01). Both groups tolerated the virtual environment well, as Simulator Sickness Questionnaire scores for both groups were minimal following completion of CC-VRS. <h3>Conclusions:</h3> The CC-VRS platform successfully quantifies PD motor symptoms and subtle cognitive declines in mild PD versus healthy controls. The CC-VRS platform was well-tolerated across groups and offers an innovative approach to objectively quantifying IADL performance, with potential for use in titrating medication and tuning deep brain stimulation parameters. <b>Disclosure:</b> Morgan McGrath has nothing to disclose. Anson Rosenfeldt has received personal compensation for serving as an employee of Cleveland Clinic. Anson Rosenfeldt has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Enspire DBS. The institution of Anson Rosenfeldt has received research support from Michael J. Fox Foundation. The institution of Anson Rosenfeldt has received research support from National Institute of Health. The institution of Anson Rosenfeldt has received research support from Department of Defense. Anson Rosenfeldt has received intellectual property interests from a discovery or technology relating to health care. Mr. Waltz has nothing to disclose. Mandy Koop has nothing to disclose. Dr. Fernandez has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Abbvie. Dr. Fernandez has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Cerevel. Dr. Fernandez has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Amneal. Dr. Fernandez has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Elsevier. The institution of Dr. Fernandez has received research support from Biogen. The institution of Dr. Fernandez has received research support from Michael J Fox Founda. The institution of Dr. Fernandez has received research support from Roche. The institution of Dr. Fernandez has received research support from Parkinson Foundation. The institution of Dr. Fernandez has received research support from UCB. Dr. Fernandez has received publishing royalties from a publication relating to health care. Dr. Fernandez has received personal compensation in the range of $10,000-$49,999 for serving as a Steering Committee/Advisory Committee Member with Parkinson Study Group. The institution of Dr. Alberts has received research support from NIH. Dr. Alberts has received intellectual property interests from a discovery or technology relating to health care. Dr. Alberts has received personal compensation in the range of $500-$4,999 for serving as a Member, Health and Wellness Council with Peloton Interactive.

SIMULATOR SICKNESS AND ITS RELATIONSHIP TO OCULOMOTOR ACTIVITY – COMPARISONS OF A FIXEDBASE VS. FULL-MOTION SIMULATOR

Introduction: Studies on simulator sickness take into account an increasing number of factors regarding individual characteristics (e.g., gender, age, experience), testing time as well as simulator testing conditions, to name a few. In addition to the symptoms of simulator sickness expressed at the level of subjective indicators, it is also important to consider physiological indicators. The present study was designed to test whether the use of a fixed-base vs. fullmotion simulator influences the severity of simulator sickness symptoms and changes in the level of oculomotor variables. Methods: Twelve male subjects with age M=29.8, SD=4.26 participated in this study. Each subject performed two 30-minute simulator tasks following the same route. Each of these tasks was performed in different configuration of a truck simulator manufactured by ETCPZL Aerospace Industries: Condition 1 – fixed-base simulator, Condition 2 – full-motion simulator. Eye movements were recorded during the simulator task. Additionally, the SSQ questionnaire was filled out immediately after the simulator task and 1 h after leaving the simulator. Results: The results show a higher level of most symptoms of simulator sickness under 2nd condition (full-motion simulator). In the case of measurement immediately after completing the task on the simulator, there was an increase in oculomotor problems. On the other hand, the measurement after 1 h also revealed a significant increase in nausea, oculomotor and disorientation. Moreover, after 1 hour, a relationship between nausea symptoms and oculomotor indices was found. Discussion and Conclusions: Results indicate the influence of simulator testing conditions on the occurrence of simulator sickness symptoms. In addition, the relationship between variables measured by the oculograph and subjective symptoms of simulator sickness was demonstrated. The results obtained indicate changes in the sensitivity of physiological indicators and are discussed in the context of the possibility of using simulators in the diagnosis and training of selected functions.

Considering the Consequences of Cybersickness in Immersive Virtual Reality Rehabilitation: A Systematic Review and Meta-Analysis

VR rehabilitation is a rapidly evolving field, with increasing research and development aimed at improving its effectiveness, accessibility, and integration into mainstream healthcare systems. While there are some commercially available VR rehabilitation programs, their adoption and use in clinical practice are still limited. One of the limitations is defined as cybersickness, which is dependent on human contact with virtual reality products. The purpose of this essay is to raise awareness of the associated elements that contribute to cybersickness in rehabilitation using immersive VR. The common factors that influence the amount of cybersickness are user characteristics and device software and hardware. The Simulator Sickness Questionnaire (SSQ) was used as one of the formal models for determining the variables related to virtual reality sickness. The systematic review of the literature and the meta-analysis were chosen by whether the Simulator Sickness Questionnaire in the articles matched the research criteria. Based on PRISMA guidelines, a systematic review of the literature was conducted. Twenty-six publications from the recent past were totaled, comprising 862 individuals with ages ranging from 19 to 95, and 49% were female. The highest overall SSQ mean score for different kinds of symptoms was determined to be 21.058 for brain injuries, with a 95% confidence interval (CI) of 15.357 to 26.760. Time, content, locomotion, control, and display types were other elements that contributed to cybersickness and had significant p-values in the SNK Q-test. The future direction of immersive VR rehabilitation involves the development of immersive and interactive environments that simulate real-world situations, providing patients with a safe and controlled environment in which to practice new skills and movements.